Pacholczak-Madej R, Kuszmiersz P, Iwaniec T, Zaręba L, Zarychta J, Walocha J A, Dropiński J, Bazan-Socha S
Department of Anatomy, Jagiellonian University, Medical College, Cracow, Poland.
National Cancer Institute, Maria Sklodowska-Curie Memorial Institute, Cracow Branch, Poland.
J Investig Allergol Clin Immunol. 2021 Oct 25;31(5):417-425. doi: 10.18176/jiaci.0563. Epub 2020 May 6.
Asthma is associated with low-grade systemic inflammation, prothrombotic state, and premature atherosclerosis. Objective: To evaluate the relationships between asthma, inflammatory biomarkers, and parameters of endothelial dysfunction.
We analyzed flow-mediated dilatation (FMD) of the brachial artery and intima-media thickness (IMT) of the common carotid artery using ultrasound in 92 clinically stable adult asthmatics and 62 well-matched controls. We also measured blood levels of selected inflammatory and asthma-specific biomarkers, including interleukin (IL) 4, IL-5, IL-6, IL-10, IL-12 (p70), IL-17A, IL-23, and interferon γ, as well as a disintegrin and metalloproteinase domain-containing protein 33 (ADAM-33). In addition, we assessed endothelial damage using 2 laboratory biomarkers: circulating von Willebrand factor (vWF) and pentraxin-3. We analyzed relationships between the study variables and asthma severity, lung function abnormalities, airway remodeling indices on computed tomography, and transthoracic echocardiography parameters.
Asthmatics had higher IL-6, IL-10, and ADAM-33 levels. They were also characterized by 23% lower FMD% and 15% thicker IMT, as compared with controls (P<.001, both). In asthma, vWF was related to age (ß=0.28 [95%CI, 0.15-0.41]) and remained inversely associated with FEV1 (ß=-0.2 [95%CI, -0.05 to -0.35]). Surprisingly, a negative correlation was revealed between vWF and pentraxin-3 (ß=-0.17 [95%CI, -0.3 to -0.04]). Pentraxin-3 remained positively associated with airway remodeling indices.
Asthma is characterized by endothelial dysfunction associated with airway obstruction. The biological role of pentraxin-3 is unknown, although our data suggest a protective role against endothelial damage and atherosclerosis.
哮喘与低度全身炎症、血栓前状态及动脉粥样硬化提前发生有关。目的:评估哮喘、炎症生物标志物与内皮功能障碍参数之间的关系。
我们采用超声分析了92例临床稳定的成年哮喘患者和62例匹配良好的对照者肱动脉的血流介导的舒张功能(FMD)和颈总动脉的内膜中层厚度(IMT)。我们还检测了选定的炎症和哮喘特异性生物标志物的血液水平,包括白细胞介素(IL)4、IL-5、IL-6、IL-10、IL-12(p70)、IL-17A、IL-23和干扰素γ,以及含解聚素和金属蛋白酶结构域蛋白33(ADAM-33)。此外,我们使用2种实验室生物标志物评估内皮损伤:循环血管性血友病因子(vWF)和五聚素-3。我们分析了研究变量与哮喘严重程度、肺功能异常、计算机断层扫描气道重塑指数及经胸超声心动图参数之间的关系。
哮喘患者的IL-6、IL-10和ADAM-33水平较高。与对照组相比,他们的FMD%降低23%,IMT增厚15%(两者P<0.001)。在哮喘中,vWF与年龄相关(β=0.28[95%CI,0.15-0.41]),并且与第一秒用力呼气容积(FEV1)仍呈负相关(β=-0.2[95%CI,-0.05至-0.35])。令人惊讶的是,vWF与五聚素-3之间呈负相关(β=-0.17[95%CI,-0.3至-0.04])。五聚素-3与气道重塑指数仍呈正相关。
哮喘的特征是与气道阻塞相关的内皮功能障碍。五聚素-3的生物学作用尚不清楚,尽管我们的数据表明其对内皮损伤和动脉粥样硬化具有保护作用。