Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
Department of Pediatrics, Tokai University Hachioji Hospital, Hachioji, Japan.
Int Arch Allergy Immunol. 2022;183(12):1270-1280. doi: 10.1159/000526408. Epub 2022 Oct 6.
Allergic sensitization is an important factor in the development, severity, and exacerbation of asthma, which is attributed to type 2 (T2) inflammation. Evidence suggests that respiratory bacterial pathogens (e.g., Streptococcus pneumoniae) exert suppressive effects on airway T2 inflammation. To clarify the role of allergic inflammation in bacterial colonization in asthma based on allergic sensitization, we investigated pharyngeal bacterial colonization, biomarkers (e.g., serum eosinophil cationic protein (ECP) and cytokines/chemokines), and symptoms in the acute exacerbation of childhood asthma.
Pharyngeal samples were collected from 53 children (mean/median age 2.7/2.5 years). Serum levels of total and allergen-specific IgE against aeroallergens, ECP, and 17 cytokines/chemokines were measured.
Allergic sensitization was recognized in 62.2% patients. S. pneumoniae, Moraxella catarrhalis, Haemophilus influenzae, and other bacteria were detected in 47.1%, 11.3%, 11.3%, and 30.1% of all patients, respectively. Patients with S. pneumoniae had a significantly shorter duration of wheezing than those without (4.7 ± 3.6 vs. 7.1 ± 3.5 days, p = 0.024). In patients with allergic sensitization, patients with S. pneumoniae had a significantly shorter duration of wheezing than those without (4.0 ± 3.6 vs. 7.7 ± 4.0 days, p = 0.003). Serum total IgE was significantly lower in patients with S. pneumoniae than in those without (81.9 [7.8-894] vs. 287 [4.4-1,840] IU/mL, p = 0.014). Serum ECP was significantly higher (33.1 [2-109] vs. 7.8 [3-35] ng/mL, p = 0.042), and IFN-γ was significantly lower (5.6 [4-10] vs. 16.4 [7-28] pg/mL, p = 0.032) in patients with allergic sensitization than those without.
DISCUSSION/CONCLUSION: Our results suggested that the suppressive effects of S. pneumoniae colonization were observed only in patients with allergic sensitization, wherein serum total IgE, ECP, and IFN-γ may have an important role on acute exacerbation of asthma.
过敏致敏是哮喘发展、严重程度和恶化的一个重要因素，这归因于 2 型（T2）炎症。有证据表明，呼吸道细菌病原体（例如肺炎链球菌）对气道 T2 炎症具有抑制作用。为了基于过敏致敏阐明细菌定植在哮喘中的过敏炎症的作用，我们研究了儿童哮喘急性加重时的咽细菌定植、生物标志物（例如血清嗜酸性粒细胞阳离子蛋白（ECP）和细胞因子/趋化因子）和症状。
从 53 名儿童（平均/中位数年龄 2.7/2.5 岁）中采集咽拭子样本。测量了总血清和过敏原特异性 IgE 对气传过敏原、ECP 和 17 种细胞因子/趋化因子的水平。
62.2%的患者存在过敏致敏。肺炎链球菌、卡他莫拉菌、流感嗜血杆菌和其他细菌在所有患者中的检出率分别为 47.1%、11.3%、11.3%和 30.1%。有肺炎链球菌的患者喘息持续时间明显短于无肺炎链球菌的患者（4.7 ± 3.6 与 7.1 ± 3.5 天，p = 0.024）。在有过敏致敏的患者中，有肺炎链球菌的患者喘息持续时间明显短于无肺炎链球菌的患者（4.0 ± 3.6 与 7.7 ± 4.0 天，p = 0.003）。有肺炎链球菌的患者血清总 IgE 明显低于无肺炎链球菌的患者（81.9 [7.8-894] 与 287 [4.4-1,840] IU/mL，p = 0.014）。血清 ECP 明显升高（33.1 [2-109] 与 7.8 [3-35] ng/mL，p = 0.042），IFN-γ 明显降低（5.6 [4-10] 与 16.4 [7-28] pg/mL，p = 0.032）在有过敏致敏的患者中。
讨论/结论：我们的结果表明，肺炎链球菌定植的抑制作用仅在过敏致敏患者中观察到，其中血清总 IgE、ECP 和 IFN-γ 可能在哮喘急性加重中起重要作用。
