Kotsiou Ourania S, Pantazopoulos Ioannis, Mavrovounis Georgios, Marsitopoulos Konstantinos, Tourlakopoulos Konstantinos, Kirgou Paraskevi, Daniil Zoe, Gourgoulianis Konstantinos I
Department of Human Pathophysiology, Faculty of Nursing, University of Thessaly, 41110 Larissa, Greece.
Department of Internal Medicine, University of Thessaly, 41500 Larissa, Greece.
J Pers Med. 2022 Oct 28;12(11):1776. doi: 10.3390/jpm12111776.
The most clinically useful concept in asthma is based on the intensity of treatment required to achieve good asthma control. Biomarkers to guide therapy are needed.
To investigate the role of circulating levels of soluble urokinase plasminogen activator receptor suPAR as a marker for asthma severity.
We recruited patients evaluated at the Asthma Clinic, University of Thessaly, Greece. Asthma severity and control were defined according to the GINA strategy and Asthma Contro Test (ACT). Anthropometrics, spirometry, fractional exhaled nitric oxide (FeNO), suPAR, blood cell count, c-reactive protein (CRP), and analyses of kidney and liver function were obtained. Patients with a history of inflammatory, infectious, or malignant disease or other lung disease, more than 5 pack years of smoking history, or corticosteroid therapy were excluded.
We evaluated 74 asthma patients (69% female, mean age 57 ± 17 years, mean body mass index (BMI) 29 ± 6 kg/m). In total, 24%, 13%, 6%, 5%, 29% and 23% of the participants had mild well-controlled, mild uncontrolled, moderate well-controlled, moderate uncontrolled, severe well-controlled, and severe uncontrolled asthma, respectively. Overall, 67% had T2-high asthma, 26% received biologics (15% and 85% received omalizumab and mepolizumab, respectively), and 34% had persistent airway obstruction. suPAR levels were significantly lower in asthmatics with moderate uncontrolled asthma than in patients with severe uncontrolled asthma without (2.1 ± 0.4 vs. 3.3 ± 0.7 ng/mL, = 0.023) or with biologics (2.1 ± 0.4 vs. 3.6 ± 0.8 ng/mL, = 0.029). No correlations were found between suPAR levels and age, BMI, T2 biomarkers, CRP, or spirometric parameters.
suPAR levels were higher in asthmatics with severe disease than in those with moderate uncontrolled asthma.
哮喘领域最具临床实用性的概念基于实现良好哮喘控制所需的治疗强度。因此需要生物标志物来指导治疗。
研究循环中可溶性尿激酶型纤溶酶原激活物受体（suPAR）水平作为哮喘严重程度标志物的作用。
我们招募了在希腊色萨利大学哮喘诊所接受评估的患者。根据全球哮喘防治创议（GINA）策略和哮喘控制测试（ACT）来定义哮喘的严重程度和控制情况。获取了人体测量数据、肺功能检查、呼出一氧化氮分数（FeNO）、suPAR、血细胞计数、C反应蛋白（CRP）以及肝肾功能分析结果。排除有炎症、感染或恶性疾病史、其他肺部疾病史、吸烟史超过5包年或接受过皮质类固醇治疗的患者。
我们评估了74例哮喘患者（69%为女性，平均年龄57±17岁，平均体重指数（BMI）29±6kg/m²）。总体而言，分别有24%、13%、6%、5%、29%和23%的参与者患有轻度控制良好、轻度控制不佳、中度控制良好、中度控制不佳、重度控制良好和重度控制不佳的哮喘。总体上，67%的患者为2型高哮喘，26%的患者接受生物制剂治疗（分别有15%和85%的患者接受奥马珠单抗和美泊利单抗），34%的患者存在持续性气道阻塞。与未接受生物制剂的重度控制不佳哮喘患者（2.1±0.4对3.3±0.7ng/mL，P = 0.023）或接受生物制剂的患者（2.1±0.4对3.6±0.8ng/mL，P = 0.029）相比，中度控制不佳哮喘患者的suPAR水平显著更低。未发现suPAR水平与年龄、BMI、2型生物标志物、CRP或肺功能参数之间存在相关性。
重症哮喘患者的suPAR水平高于中度控制不佳哮喘患者。
