Zhang Xi, Duan Xiaojun, Chen Yuan, Wang Lili, Chen Yanping
Department of Respiratory Medicine, Hunan Children's Hospital, Changsha, China.
Research Institute of Children, Hunan Children's Hospital, Changsha, China.
DNA Cell Biol. 2025 Jan;44(1):46-53. doi: 10.1089/dna.2024.0146. Epub 2024 Nov 6.
The early and precise diagnosis of asthma significantly impacts the long-term health outcomes of pediatric patients. The sensitivity and specificity of current biomarkers, however, are frequently limited. Our study aimed to evaluate the clinical significance of nuclear factor of activated T cells, cytoplasmic 3 (NFATc3), in pediatric bronchial asthma, focusing on its diagnostic and prognostic value for disease severity and recurrence. This observational, prospective case-control study involved 200 pediatric patients with bronchial asthma and 200 age- and sex-matched healthy controls, from January 2020 to January 2023. Follow-up varied from 1 to 3 years. We measured levels of NFATc3 and inflammatory cytokines interleukin-1β (IL-1β), IL-6, and TNF-α via enzyme-linked immunosorbent assay. NFATc3 and IL-1β levels at enrollment were markedly higher in patients with acute exacerbations and those classified as severe, compared with their less severe counterparts. Throughout the study, NFATc3, IL-1β, and IL-6 levels significantly increased in severe or acutely exacerbating cases. The diagnostic value of NFATc3 was assessed through receiver operating characteristic curve analysis, which showed its potential in diagnosing bronchial asthma and identifying severe cases. Spearman's analysis confirmed positive associations between peak NFATc3 and cytokine levels. Importantly, disease type, NFATc3 values at enrollment, as well as peak IL-6 levels were identified as independent risk factors for severe bronchial asthma. Elevated NFATc3 is linked with the severity of pediatric bronchial asthma and serves as a potential biomarker for diagnosis and severity prediction, emphasizing its role in guiding treatment strategies.
哮喘的早期准确诊断对儿科患者的长期健康结局有重大影响。然而，目前生物标志物的敏感性和特异性常常有限。我们的研究旨在评估活化T细胞核因子3（NFATc3）在小儿支气管哮喘中的临床意义，重点关注其对疾病严重程度和复发的诊断及预后价值。这项观察性、前瞻性病例对照研究纳入了200例小儿支气管哮喘患者和200例年龄及性别匹配的健康对照，研究时间为2020年1月至2023年1月。随访时间为1至3年。我们通过酶联免疫吸附测定法测量了NFATc3和炎性细胞因子白细胞介素-1β（IL-1β）、IL-6及肿瘤坏死因子-α的水平。与病情较轻的患者相比，急性加重期患者及被归类为重度的患者在入组时的NFATc3和IL-1β水平明显更高。在整个研究过程中，重度或急性加重病例的NFATc3、IL-1β和IL-6水平显著升高。通过受试者工作特征曲线分析评估了NFATc3的诊断价值，结果显示其在诊断支气管哮喘和识别重症病例方面具有潜力。Spearman分析证实NFATc3峰值与细胞因子水平之间存在正相关。重要的是，疾病类型、入组时的NFATc3值以及IL-6峰值水平被确定为重度支气管哮喘的独立危险因素。NFATc3升高与小儿支气管哮喘严重程度相关，可作为诊断和严重程度预测的潜在生物标志物，强调了其在指导治疗策略方面的作用。
