改善饮食质量与未控制的哮喘成人炎症标志物浓度降低有关。
Improved diet quality is associated with decreased concentrations of inflammatory markers in adults with uncontrolled asthma.
机构信息
Sean N Parker Center for Allergy and Asthma Research, Division of Pulmonary and Critical Care Medicine and Division of Allergy, Immunology and Rheumatology, Stanford University, Stanford, CA, USA.
Department for Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.
出版信息
Am J Clin Nutr. 2021 Sep 1;114(3):1012-1027. doi: 10.1093/ajcn/nqab063.
BACKGROUND
Asthma has become one of the major public health challenges, and recent studies show promising clinical benefits of dietary interventions, such as the Dietary Approaches to Stop Hypertension (DASH) diet.
OBJECTIVE
The objective of this study was to examine whether changes in diet quality are associated with changes in inflammatory markers important in asthma pathophysiology.
METHODS
In this exploratory study in patients with poorly controlled asthma participating in a randomized controlled trial of a DASH intervention study, changes in concentrations of a broad panel of serum proteins (51-plex Luminex assay, Affymetrix) were determined, and their relation to diet quality (DASH score) assessed by combining data of both intervention and usual-care control groups. Second, the relation between the serum proteins, other biomarkers of inflammation and nutrition, and Asthma Control Questionnaire (ACQ) was assessed.
RESULTS
During the first 3 mo, diet quality (DASH scores) were inversely associated (P < 0.05, false discovery rate P < 0.09) with serum concentrations of a large number serum proteins, reflecting not only general proinflammatory markers such as IL-1β, transforming growth factor α (TGF-α), and IL-6 (r = -0.31 to -0.39) but also a number of proteins associated with asthmatic conditions, specifically several T-helper (Th) 2 (Th2; r = -0.29 to -0.34) and Th17 (r = -0.4) associated cytokines and growth factors. Monokine induced by gamma/chemokine (C-X-C motif) ligand 9 (CXCL9) (MIG/CXCL9), a T-cell attractant induced by IFN-γ previously linked to asthma exacerbations, appeared to be the marker most consistently associated with DASH diet quality for the entire 6-mo study period (r = -0.40 and -0.30 for 0-3 and 3-6 mo, respectively, and standardized coefficient loadings -0.13 in the partial least squares analyses). Decreases in 19 serum protein concentrations were also correlated with improved asthma control during the 6-mo study period.
CONCLUSIONS
Our data in adult patients with poorly controlled asthma suggest that dietary changes, like the introduction of DASH, may have beneficial effects on reducing inflammatory status. This trial was registered at http://www.clinicaltrials.gov as NCT01725945.
背景
哮喘已成为主要的公共卫生挑战之一，最近的研究表明，饮食干预措施具有有前景的临床获益，例如膳食干预以停止高血压（DASH）饮食。
目的
本研究旨在探讨饮食质量的变化是否与哮喘病理生理学中重要的炎症标志物的变化相关。
方法
在这项参与 DASH 干预研究的随机对照试验的控制不佳的哮喘患者的探索性研究中，确定了广泛的血清蛋白浓度的变化（51 元 Luminex 分析，Affymetrix），并通过结合干预和常规护理对照组的数据来评估饮食质量（DASH 评分）与这些变化的关系。其次，评估了血清蛋白与其他炎症和营养生物标志物与哮喘控制问卷（ACQ）之间的关系。
结果
在最初的 3 个月中，饮食质量（DASH 评分）与许多血清蛋白的浓度呈负相关（P<0.05，错误发现率 P<0.09），反映了不仅一般的促炎标志物如白细胞介素-1β（IL-1β）、转化生长因子-α（TGF-α）和白细胞介素-6（IL-6）（r=-0.31 至-0.39），而且与哮喘情况相关的许多蛋白，特别是几种辅助性 T 细胞（Th2；r=-0.29 至-0.34）和 Th17（r=-0.4）相关细胞因子和生长因子。γ/趋化因子（C-X-C 基序）配体 9（CXCL9）诱导的单核细胞因子（MIG/CXCL9）是一种由 IFN-γ诱导的 T 细胞趋化因子，先前与哮喘恶化有关，似乎是与整个 6 个月研究期间 DASH 饮食质量最一致相关的标志物（0-3 个月和 3-6 个月的 r 值分别为-0.40 和-0.30，偏最小二乘分析的标准化系数负荷为-0.13）。在 6 个月的研究期间，19 种血清蛋白浓度的降低也与哮喘控制的改善相关。
结论
我们在控制不佳的成年哮喘患者中的数据表明，饮食变化，如 DASH 的引入，可能对减轻炎症状态具有有益作用。该试验在 http://www.clinicaltrials.gov 注册，注册号为 NCT01725945。
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