Zhu Wanting, Yu Wenting, Gao Pei, Zhang Qidi, Zhou Yue, Wang Yanjun, Chen Jianjun
Department of Otolaryngology Head and Neck Surgery,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr;35(4):306-311;315. doi: 10.13201/j.issn.2096-7993.2021.04.005.
This study aimed to explore the biomarkers in nasal secretion that can assist in the diagnosis of allergic rhinitis(AR) and can be used to evaluate the therapeutic effect of AR. Thirty-three patients with AR and 21 healthy controls were included. The nasal secretion of healthy controls and patients with AR(before and after treatment) were collected. The cytology, the concentrations of cytokines(IL-5, IL-6, IL-8, IL-33, IFN-γ) and inflammatory mediators(ECP, MPO) were detected. Then, we compared the differences of various biomarkers between healthy controls and AR patients(before and after treatment group). And analyzed the correlation between each biomarkers/biomarkers difference value/the percentage of biomarkers difference value and clinical symptom score/ score difference value / the percentage of score difference value. Compared with normal controls, the levels of ECP, IL-5, IL-6, IL-8, IL-33 and IFN-γ in nasal secretion of AR patients were significantly higher than those of normal controls(<0.05). There was no significant difference in MPO. After treatment, ECP decreased significantly(<0.01), inflammatory cell grade and eosinophil percentage are also decreased(<0.01). However, MPO, IL-5, IL-6, IL-8, IL-33 and IFN-γ did not change significantly. The difference value of ECP before and after treatment was correlated with the difference value of VAS score(=0.348, =0.047). The difference value of IL-5 was correlated with the difference value of VAS score and rhinorrhea, the correlation coefficients were 0.406(=0.019) and 0.429(=0.013), respectively. The difference value of eosinophil percentage in nasal secretion before and after treatment was correlated with nasal congestion, and the correlation coefficient was 0.383. The difference value of eosinophil percentage multiplied by inflammatory cell grade before and after treatment was correlated with VAS score(=0.417, =0.016) and nasal congestion difference value(=0.519, =0.002). The percentage of difference value of IFN-γ before and after treatment was correlated with the percentage of difference value of VAS score / rhinorrhea / sneeze / total nasal symptom score. ECP, IL-6, IL-8 and IL-33 in nasal secretion are expected to be objective biomarkers for auxiliary diagnosis of AR. And ECP, IL-5, IFN-γ, eosinophil percentage multiplied by grade is expected to be an objective index to judge the improvement of patients' symptoms after treatment.
本研究旨在探索鼻分泌物中的生物标志物,其可辅助诊断变应性鼻炎(AR)并用于评估AR的治疗效果。纳入了33例AR患者和21名健康对照者。收集健康对照者以及AR患者(治疗前后)的鼻分泌物。检测其细胞学、细胞因子(IL-5、IL-6、IL-8、IL-33、IFN-γ)浓度及炎症介质(ECP、MPO)。然后,比较健康对照者与AR患者(治疗前后组)之间各种生物标志物的差异。并分析各生物标志物/生物标志物差值/生物标志物差值百分比与临床症状评分/评分差值/评分差值百分比之间的相关性。与正常对照相比,AR患者鼻分泌物中ECP、IL-5、IL-6、IL-8、IL-33和IFN-γ水平显著高于正常对照(<0.05)。MPO无显著差异。治疗后,ECP显著下降(<0.01),炎症细胞分级及嗜酸性粒细胞百分比也下降(<0.01)。然而,MPO、IL-5、IL-6、IL-8、IL-33和IFN-γ无显著变化。治疗前后ECP的差值与VAS评分差值相关(=0.348,=0.047)。IL-5的差值与VAS评分差值及流涕相关,相关系数分别为0.406(=0.019)和0.429(=0.013)。治疗前后鼻分泌物中嗜酸性粒细胞百分比的差值与鼻塞相关,相关系数为0.383。治疗前后嗜酸性粒细胞百分比乘以炎症细胞分级的差值与VAS评分(=0.417,=0.016)及鼻塞差值(=0.519,=0.002)相关。治疗前后IFN-γ差值百分比与VAS评分/流涕/喷嚏/总鼻症状评分差值百分比相关。鼻分泌物中的ECP、IL-6、IL-8和IL-33有望成为AR辅助诊断的客观生物标志物。并且ECP、IL-5、IFN-γ、嗜酸性粒细胞百分比乘以分级有望成为判断患者治疗后症状改善的客观指标。