Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA,
Department of Biomolecular Chemistry, University of Wisconsin, Madison, Wisconsin, USA.
Int Arch Allergy Immunol. 2020;181(11):879-887. doi: 10.1159/000509600. Epub 2020 Aug 10.
Severe asthma has multiple phenotypes for which biomarkers are still being defined. Plasma P-selectin reports endothelial and/or platelet activation.
To determine if P-selectin is associated with features of asthma in a longitudinal study.
Plasmas from 70 adult patients enrolled in the Severe Asthma Research Program (SARP) III at the University of Wisconsin-Madison were analyzed for concentration of P-selectin at several points over the course of 3 years, namely, at baseline (BPS), after intramuscular triamcinolone acetonide (TA) injection, and at 36 months after baseline. Thirty-four participants also came in during acute exacerbation and 6 weeks after exacerbation.
BPS correlated inversely with forced expiratory volume in 1 s (FEV1) and with residual volume/total lung capacity, an indicator of air trapping. BPS was inversely associated with FEV1 change after TA, by regression analysis. FEV1 did not change significantly after TA if BPS was above the median, whereas patients with BPS below the median had significantly increased FEV1 after TA. BPS was higher in and predicted assignment to SARP phenotype cluster 5 ("severe fixed-airflow asthma"). P-selectin was modestly but significantly increased at exacerbation but returned to baseline within 3 years.
High BPS is associated with airway obstruction, air trapping, the "severe fixed-airflow" cluster, and lack of FEV1 improvement in response to TA injection. P-selectin concentration, which is a stable trait with only modest elevation during exacerbation, may be a useful biomarker for a severe asthma pheno- or endotype characterized by low pulmonary function and lack of corticosteroid responsiveness.
重度哮喘具有多种表型，目前仍在定义其生物标志物。血浆 P 选择素报告内皮细胞和/或血小板活化。
在一项纵向研究中，确定 P 选择素是否与哮喘的特征有关。
在威斯康星大学麦迪逊分校严重哮喘研究计划（SARP）III 中招募的 70 名成年患者的血浆中，在 3 年内的几个时间点分析 P 选择素的浓度，即基线时（BPS）、肌肉内曲安奈德（TA）注射后和基线后 36 个月。34 名参与者还在急性加重期间和加重后 6 周时入组。
BPS 与 1 秒用力呼气量（FEV1）和残气量/总肺容量呈负相关，残气量/总肺容量是空气滞留的指标。通过回归分析，BPS 与 TA 后 FEV1 的变化呈负相关。如果 BPS 高于中位数，TA 后 FEV1 没有显著变化，而 BPS 低于中位数的患者 TA 后 FEV1 显著增加。BPS 在 SARP 表型聚类 5（“严重固定气流哮喘”）中较高，并预测其分配。P 选择素在加重时略有但显著增加，但在 3 年内恢复到基线。
高 BPS 与气道阻塞、空气滞留、“严重固定气流”聚类以及 TA 注射后 FEV1 改善缺乏相关。P 选择素浓度是一种稳定的特征，在加重期间仅有适度升高，可能是一种有用的生物标志物，用于预测肺功能低和对皮质类固醇反应性差的严重哮喘表型或内型。
