Department of Pediatrics, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
Department of Biochemistry and Genetics, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
BMC Pediatr. 2022 Sep 8;22(1):534. doi: 10.1186/s12887-022-03596-5.
In community-acquired pneumonia (CAP), pulmonary vascular endothelial dysfunction, inflammation, and oxidative stress (OS) are prominent and interesting as the unfavorable clinical outcomes of it. Asthma as a common chronic respiratory disease may affect the clinical outcomes of pneumonia, but the exact mechanism of this effect remains unclear. The present study aimed to assess the effects of asthma on the OS, inflammation, and endothelial dysfunction biomarkers in the children pneumonia.
A cross-sectional study designed with a total of 75 children including both severe CAP and asthma (as group I), severe CAP alone (as group II), and healthy children (as group III) was conducted. Fasting blood samples were taken to the assay of serum malondialdehyde (MDA), total antioxidant capacity (TAC), tumor necrosis factor-alpha (TNF-α), soluble vascular cell adhesion molecule-1 (sVCAM-1), and plasminogen activator inhibitor-1 (PAI-1). The mean of anthropometric and biochemical parameters was compared by ANOVA and Tukey post-hoc test between groups.
We observed TAC levels in groups I and II (0.997 ± 0.22 and 1.23 ± 0.21 mmol/l, respectively) were significantly lower compared with group III (1.46 ± 0.19 mmol/l, P value < 0.001). It was significantly higher in group II than in group I (P value < 0.001). Also, we observed MDA and TNF-α levels in groups I (6.94 ± 1.61 μmol/l, 7.34 ± 2.23 pg/ml, respectively) and II (2.57 ± 0.40 μmol/l, 5.54 ± 1.84 pg/ml, respectively) were significantly higher compared with group III (1.89 ± 0.27 μmol/l, 3.42 ± 1.32 pg/ml, P value < 0.001, P value < 0.001, respectively). VCAM-1 and PAI-1 levels as the endothelial dysfunction biomarkers were significantly higher in group I (1.5 ± 0.62 mmol/l, 10.52 ± 3.2 AU/ml, respectively) compared with groups II (1.06 ± 0.53 mmol/l and 8.23 ± 3.4 AU/ml; P value < 0.001, P value < 0.001, respectively) and III (0.6 ± 0.35 mmol/l and 2.39 ± 0.83 AU/ml; P value < 0.001, P value < 0.001, respectively). Also, VCAM-1 and PAI-1 levels were significantly higher in group II compared with groups III (P value < 0.001, P value < 0.001).
Asthma can exacerbate the vascular dysfunction of pneumonia in children by increasing oxidative stress, inflammation, and endothelial dysfunction.
在社区获得性肺炎（CAP）中，肺血管内皮功能障碍、炎症和氧化应激（OS）非常突出，这也是其临床预后不良的原因。哮喘作为一种常见的慢性呼吸道疾病，可能会影响肺炎的临床结局，但这种影响的确切机制仍不清楚。本研究旨在评估哮喘对儿童肺炎患者 OS、炎症和内皮功能障碍生物标志物的影响。
采用横断面研究设计，共纳入 75 例儿童，包括重症 CAP 合并哮喘（I 组）、单纯重症 CAP（II 组）和健康儿童（III 组）。采集空腹血样，检测血清丙二醛（MDA）、总抗氧化能力（TAC）、肿瘤坏死因子-α（TNF-α）、可溶性血管细胞黏附分子-1（sVCAM-1）和纤溶酶原激活物抑制剂-1（PAI-1）水平。采用方差分析和 Tukey 事后检验比较组间人体测量学和生化参数的平均值。
我们观察到 I 组和 II 组的 TAC 水平（分别为 0.997±0.22 和 1.23±0.21mmol/L）明显低于 III 组（1.46±0.19mmol/L，P 值<0.001）。II 组的 TAC 水平明显高于 I 组（P 值<0.001）。此外，我们还观察到 I 组和 II 组的 MDA 和 TNF-α水平（分别为 6.94±1.61μmol/L、7.34±2.23pg/ml 和 2.57±0.40μmol/L、5.54±1.84pg/ml）明显高于 III 组（1.89±0.27μmol/L、3.42±1.32pg/ml，P 值<0.001，P 值<0.001）。作为内皮功能障碍生物标志物的 VCAM-1 和 PAI-1 水平在 I 组（分别为 1.5±0.62mmol/L、10.52±3.2AU/ml）明显高于 II 组（分别为 1.06±0.53mmol/L 和 8.23±3.4AU/ml；P 值<0.001，P 值<0.001）和 III 组（分别为 0.6±0.35mmol/L 和 2.39±0.83AU/ml；P 值<0.001，P 值<0.001）。此外，VCAM-1 和 PAI-1 水平在 II 组明显高于 III 组（P 值<0.001，P 值<0.001）。
哮喘可通过增加氧化应激、炎症和内皮功能障碍，加重儿童肺炎的血管功能障碍。
