Kharkiv National Medical University, Kharkiv, Ukraine.
Adv Respir Med. 2020;88(4):320-326. doi: 10.5603/ARM.a2020.0108.
Asthma diagnosis in young children may represent a clinical challenge. There are no standard prognostic and dia-gnostic methods. The aim of the study was to evaluate the clinical and prognostic assessment of IL-4 and IL-13 concentrations in children with recurrent wheezing.
The study included 96 children with recurrent wheezing. 81 patients were diagnosed as transient wheezing, 15 patients with asthma, and 25 healthy children were selected as controls. The concentrations of IL-4 and IL-13 were analyzed in exhaled breath condensate (EBC) using an enzyme-linked immunosorbent assay (ELISA). Data analysis was performed using Statsoft Statistica Version 8 (Tulsa, OK) and the statistical program MedCalc version 17.2.
Both IL-4 and IL-13 concentrations were significantly higher in DDA (21.13 pg/mL, 26.13 pg/mL, respectively) and TW (13.86 pg/mL, 18.3 pg/mL, respectively) groups as compared to healthy controls (3.37 pg/mL, 16.35 pg/mL, respectively; p<0.001), and the highest rates were observed in children with diagnosed asthma (p < 0.001, DDW vs TW, respectively). IL-4 concentration higher than 18.45 pg/mL (with sensitivity 86.7% and specificity 80%) and IL-13 concentration higher than 20.17pg/ /mL (with sensitivity 100% and specificity 76.7%) in EBC in children with wheezing recurrence can be considered as a possible predictor of asthma development.
The concentration of the anti-inflammatory cytokines IL-4 and IL-13 were significantly increased in children with recurrent wheezing and the highest rates were found in asthma developing children. The concentrations of IL-4 and IL-13 in chil-dren with wheezing can be considered as a possible predictor of asthma development.
儿童哮喘的诊断可能具有临床挑战性。目前尚无标准的预测和诊断方法。本研究旨在评估白细胞介素-4(IL-4)和白细胞介素-13(IL-13)浓度在反复喘息儿童中的临床和预后评估价值。
本研究纳入了 96 例反复喘息的患儿。81 例患儿被诊断为一过性喘息,15 例患儿被诊断为哮喘,25 例健康儿童被选为对照组。采用酶联免疫吸附试验(ELISA)检测呼出气冷凝液(EBC)中 IL-4 和 IL-13 的浓度。使用 Statsoft Statistica Version 8(塔尔萨,俄克拉荷马州)和 MedCalc 版本 17.2 统计程序进行数据分析。
DDW(21.13 pg/mL,26.13 pg/mL)和 TW(13.86 pg/mL,18.3 pg/mL)组的 IL-4 和 IL-13 浓度均显著高于健康对照组(3.37 pg/mL,16.35 pg/mL;p<0.001),且在确诊哮喘的患儿中浓度最高(p<0.001,DDW 与 TW 相比)。EBC 中 IL-4 浓度高于 18.45 pg/mL(敏感性 86.7%,特异性 80%),IL-13 浓度高于 20.17 pg/mL(敏感性 100%,特异性 76.7%),可作为喘息反复发作患儿发生哮喘的可能预测指标。
在反复喘息的儿童中,抗炎细胞因子 IL-4 和 IL-13 的浓度显著升高,且在发展为哮喘的儿童中浓度最高。喘息儿童中 IL-4 和 IL-13 的浓度可作为哮喘发展的可能预测指标。