Lin Ching-Hsiung, Li Yi-Rong, Kor Chew-Teng, Lin Sheng-Hao, Ji Bin-Chuan, Lin Ming-Tai, Chai Woei-Horng
Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan.
Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung 402, Taiwan.
Biomedicines. 2022 Jun 19;10(6):1452. doi: 10.3390/biomedicines10061452.
Sensitization to fungal allergens is one of the proposed phenotypes in asthma. An association between fungal sensitization and worse clinical outcomes is apparent. Moreover, fungal sensitization in asthma that is associated with different type of immunological mechanism has been reported. How the role of cytokines mediates the association between fungal sensitization and poorer asthmatic outcomes remains unclear. We aimed to determine role of cytokines in the relationship between fungal sensitization and worse clinical outcomes in asthma.
We conducted a prospective study to recruit adult patients with asthma. Data including age, sex, height, weight, smoking history, medication, emergency visit and admission, pulmonary function testing result, and Asthma Control Test (ACT) scores were collected. We used the automated BioIC method to measure fungal allergen sIgE in sera. Serum levels of Interleukin (IL) -4, IL-13, IL-6, IL-9, IL-10, IL-17 A, IL-22, Interferon (IFN) -γ, Immunoglobulin E (IgE), Tumor necrosis factor-α (TNF-α), and Transforming growth factor-β (TGF-β) were measured using ELISA.
IL-6 and IL-17A had a significant positive correlation between sensitization and most fungi species compared to IgE. Sensitization to had strongly positive association both with IL-6 and IL-17A. However, only IL-17A had significant relationship with ED visit times. The mediation analysis result indicates that IL-17A had a significant positively mediating effect (ME) on the association between and ED visit times.
IL-17A is a potential mediator to link sensitization and ED visits for asthma. We suggest that patients with fungal sensitization, such as , have poorer outcomes associated with Th17-mediated immune response rather than Th2.
对真菌过敏原致敏是哮喘中提出的表型之一。真菌致敏与更差的临床结局之间的关联很明显。此外，已经报道了哮喘中的真菌致敏与不同类型的免疫机制相关。细胞因子的作用如何介导真菌致敏与较差哮喘结局之间的关联仍不清楚。我们旨在确定细胞因子在真菌致敏与哮喘较差临床结局之间关系中的作用。
我们进行了一项前瞻性研究，招募成年哮喘患者。收集的数据包括年龄、性别、身高、体重、吸烟史、用药情况、急诊就诊和住院情况、肺功能测试结果以及哮喘控制测试（ACT）分数。我们使用自动BioIC方法测量血清中的真菌过敏原特异性IgE。使用酶联免疫吸附测定法（ELISA）测量血清白细胞介素（IL）-4、IL-13、IL-6、IL-9、IL-10、IL-17A、IL-22、干扰素（IFN）-γ、免疫球蛋白E（IgE）、肿瘤坏死因子-α（TNF-α）和转化生长因子-β（TGF-β）的水平。
与IgE相比，IL-6和IL-17A在致敏与大多数真菌种类之间存在显著正相关。对[此处原文缺失致敏对象]致敏与IL-6和IL-17A均有强正相关。然而，只有IL-17A与急诊就诊次数有显著关系。中介分析结果表明，IL-17A对[此处原文缺失致敏对象]与急诊就诊次数之间的关联有显著的正向中介作用（ME）。
IL-17A是连接[此处原文缺失致敏对象]致敏与哮喘急诊就诊的潜在中介因子。我们建议，对真菌致敏的患者，如[此处原文缺失致敏对象]，其结局较差与Th17介导的免疫反应而非Th2相关。
