Assistant, Department of Ear, Nose, and Throat; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
Associate Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
Sovrem Tekhnologii Med. 2021;12(5):37-45. doi: 10.17691/stm2020.12.5.04. Epub 2020 Oct 28.
The involvement of periostin in Th2-dependent allergic inflammation has been documented. However, the significance of periostin as a biomarker of local allergic inflammation in the nasal mucosa (NM) of patients with atopic bronchial asthma (BA) and allergic rhinitis (AR) is yet to be determined. was to determine the presence of periostin and evaluate its role as a non-invasive marker of allergic inflammation in the nasal secretions of children with atopic BA and AR.
In 43 patients aged 4-17 years with atopic BA and AR, the NM was examined using nasal video-endoscopy and (if indicated) computed tomography; the amount of periostin in the nasal secretion was determined by the enzyme immunoassay.
Exacerbation of AR was accompanied by a statistically significant increase in the level of periostin in the nasal secretion: up to 0.84 [0.06; 48.79] ng/mg, whereas in remission, that was 0.13 [0.00; 0.36] ng/mg; p=0.04. This value increased progressively as the severity of AR increased from 0.16 [0.00; 0.36] ng/mg in the mild course to 0.20 [0.00; 9.03] ng/mg in AR of moderate severity, and to 10.70 [0.56; 769.20] ng/mg in most severe cases; p=0.048. Hypertrophy or polyposis of the nasal and/or paranasal mucosa was detected in 34.9% (15/43) of the examined patients. The concentration of periostin in the nasal secretion was lower in children without NM hypertrophy: 0.18 [0.001; 4.30] ng/mg vs 0.78 [0.13; 162.10] ng/mg in patients with NM hypertrophy; the differences were close to statistically significant: p=0.051. The level of nasal periostin depended on the clinical form of hypertrophy in the sinonasal mucosa, reaching 0.17 [0.00; 0.32] ng/mg in children with polyposis hyperplasia of NM and 21.6 [10.70; 1516.80] ng/mg - with hypertrophy of the NM in the medial surface of the concha; p=0.02.
Exacerbation and increased severity of AR in patients with atopic BA are accompanied by an increased level of periostin in the nasal secretion. This allows us to consider the level of nasal periostin as a biomarker of local allergic inflammation in the NM of patients with atopic BA combined with AR. Hypertrophic changes in the sinonasal mucosa are generally accompanied by an increased level of nasal periostin; specifically, this level significantly depends on the clinical form of mucous membrane hypertrophy and requires additional studies.
确定骨桥蛋白的存在，并评估其作为变应性炎症的非侵入性标志物在患有特应性支气管哮喘（BA）和变应性鼻炎（AR）的儿童鼻分泌物中的作用。
在 43 名年龄在 4-17 岁的患有特应性 BA 和 AR 的患者中，使用鼻内视频内镜（如果需要，还使用计算机断层扫描）检查鼻黏膜（NM）；通过酶免疫测定法测定鼻分泌物中骨桥蛋白的含量。
AR 加重时，鼻分泌物中骨桥蛋白水平呈统计学显著升高：高达 0.84 [0.06；48.79] ng/mg，而在缓解期，为 0.13 [0.00；0.36] ng/mg；p=0.04。随着 AR 严重程度从轻度的 0.16 [0.00；0.36] ng/mg 增加到中度的 0.20 [0.00；9.03] ng/mg，再增加到严重程度的 10.70 [0.56；769.20] ng/mg，该值呈进行性增加；p=0.048。在接受检查的患者中，有 34.9%（15/43）的患者检测到 NM 肥大或息肉。在没有 NM 肥大的儿童中，鼻分泌物中骨桥蛋白的浓度较低：0.18 [0.001；4.30] ng/mg vs 0.78 [0.13；162.10] ng/mg 在 NM 肥大的患者中；差异接近统计学意义：p=0.051。鼻骨桥蛋白的水平取决于鼻黏膜肥大的临床形式，在 NM 息肉样增生的儿童中达到 0.17 [0.00；0.32] ng/mg，在鼻甲内表面 NM 肥大的儿童中达到 21.6 [10.70；1516.80] ng/mg；p=0.02。
患有特应性 BA 的患者的 AR 加重和严重程度增加伴随着鼻分泌物中骨桥蛋白水平的升高。这使得我们可以将鼻骨桥蛋白的水平视为患有特应性 BA 合并 AR 的患者 NM 局部变应性炎症的生物标志物。鼻黏膜肥大的一般变化伴随着鼻骨桥蛋白水平的升高；具体而言，该水平显著取决于黏膜肥大的临床形式，需要进一步研究。
