支气管哮喘患儿血清骨膜蛋白水平变化及其意义

doi:10.13481/j.1671-587x.20170120

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (01): 101-105.doi: 10.13481/j.1671-587x.20170120

支气管哮喘患儿血清骨膜蛋白水平变化及其意义

李艳凤¹, 王洪波¹, 高阳¹, 郑雨轩², 刘丽¹

1. 吉林大学第一医院小儿呼吸一科, 吉林长春 130021;
2. 吉林大学第一医院转化医学研究院, 吉林长春 130061

收稿日期:2016-06-23 出版日期:2017-01-28 发布日期:2017-02-08
通讯作者: 刘丽,副教授,主任医师,硕士研究生导师(Tel:0431-88782975,E-mail:liuli0205@163.com) E-mail:liuli0205@163.com
作者简介:李艳凤(1989-),女,山东省聊城市人,在读医学硕士,主要从事小儿支气管哮喘的基础和临床方面的研究。
基金资助:
国家卫计委医药卫生科技发展研究中心科研项目资助课题（W2015EAE009）

Change of serum periostinlevel in children with bronchial asthma and significance

LI Yanfeng¹, WANG Hongbo¹, GAO Yang¹, ZHENG Yuxuan², LIU Li¹

1. First Department of Pediatric Respiratory Medicine, First Hospital, Jilin University, Changchun 130021, China;
2. Institute of Translational Medicine, First Hospital, Jilin University, Changchun 130061, China

Received:2016-06-23 Online:2017-01-28 Published:2017-02-08

摘要/Abstract

摘要：

目的：探讨支气管哮喘患儿血清中骨膜蛋白水平的变化，阐明其在哮喘中的作用。方法：随机选取支气管哮喘患儿65例作为观察组，健康儿童50人作为对照组，采用酶联免疫吸附测定（ELISA）法检测受试者外周血中骨膜蛋白、IgE和嗜酸细胞阳离子蛋白（ECP）水平及嗜酸性粒细胞计数，并检测呼出气一氧化氮（FeNO）、一秒用力呼气容积占预计值百分比（FEV₁% pred）、用力肺活量（FVC）和FEV₁/FVC比值。结果：与对照组比较，观察组患儿外周血中骨膜蛋白、IgE和ECP水平、嗜酸性粒细胞计数和FeNO均明显升高（P<0.05），FEV₁% pred和FEV₁/FVC比值均明显降低（P<0.05）；采用血清骨膜蛋白水平诊断哮喘，受试者工作特征曲线（ROC曲线）下面积（AUC）为0.668（P=0.02），骨膜蛋白水平诊断哮喘界点为80.89 μg·L^-1（95% CI：0.570~0.766），灵敏度为29.23%，特异度为92.00%；骨膜蛋白水平与嗜酸性粒细胞计数和FeNO呈正相关关系（r=0.519，P=0.019；r=0.602，P=0.008）。结论：哮喘患儿血清中骨膜蛋白水平升高，骨膜蛋白可以作为初步排查儿童哮喘的指标，抑制Th2介导的炎性反应过程是治疗哮喘的靶点。

关键词: 骨膜蛋白, 气道高反应性, 支气管哮喘, 酶联免疫吸附测定

Abstract:

Objective: To explore the change of serum periostin level in peripheral blood of the children with bronchial asthma,and to clarify its role in asthma.Methods: Sixty-five children with bronchial asthma were randomly chosen as observation group,and 50 healthy children were also randomly chosen as control group.The levels of periostin,IgE,eosinophil cationic protein(ECP) and the number of eosinophils in peripheral blood of all subjects were detected by enzyme-linked immunosorbent assay (ELISA). The fractional exhaled nitric oxide (FeNO) levels and pulmonary function test indexes including forced expiratory volume in one second/predicted value ratio (FEV₁% pred),forced vital capacity (FVC) and FEV₁/FVC ratio were also detected.Results: Compared with control group,the serum periostin,IgE,and ECP levels,the number of eosinophils and FeNO in observation group were significantly increased (P<0.05),while the FEV₁%pred and FEV₁/FVC ratio were significantly decreased (P<0.05).The area under ROC curve (AUC) was 0.668 (P=0.02) and the threshold for periostin to identify asthma was 80.89 μg·L^-1 (95% CI:0.570-0.766) with the sensitivity of 29.23% and specificity of 92.00%. Periostin was positively correlated with the eosinophil count as well as FeNO (r=0.519, P=0.019;r=0.602,P=0.008).Conclusion: The periostin level in peripheral blood of the children with asthma is significantly increased and it can be used as a preliminary indicator to rule out asthma in the children.Inhibiting Th2-mediated inflammatory response is one target for the treatment of asthma.

Key words: bronchial asthma, airway hyperresponsiveness, enzyme-linked immunosorbent assay, periosteum protein

中图分类号:

R725.6

李艳凤, 王洪波, 高阳, 郑雨轩, 刘丽. 支气管哮喘患儿血清骨膜蛋白水平变化及其意义[J]. 吉林大学学报(医学版), 2017, 43(01): 101-105.

LI Yanfeng, WANG Hongbo, GAO Yang, ZHENG Yuxuan, LIU Li. Change of serum periostinlevel in children with bronchial asthma and significance[J]. Journal of Jilin University Medicine Edition, 2017, 43(01): 101-105.

参考文献

[1] Beasley R,Semprini A,Mitchell EA.Risk factors for asthma:is prevention possible[J].Lancet,2015,386(9998):1075-1085.
[2] Bartminski G,Crossley M,Turcanu V.Novel biomarkers for asthma stratification and personalized therapy[J].Expert Rev Mol Diagn,2015,15(3):415-430.
[3] Parulekar AD,Atik MA,Hanania NA.Periostin,a novel biomarker of TH2-driven asthma[J].Curr Opin Pulm Med,2014,20(1):60-65.
[4] Kanemitsu Y,Matsumoto H,Izuhara K,et al.Increased periostin associates with greater airflow limitation in patients receiving inhaled corticosteroids[J].J Allergy Clin Immunol,2013,132(2):305-312.
[5] Nair P,Kraft M.Serum periostin as a marker of T(H)2-dependent eosinophilic airway inflammation[J].J Allergy Clin Immunol,2012,130(3):655-656.
[6] Bobolea I,Barranco P,DelPozo V,et al.Sputum periostin in patients with different severe asthma phenotypes[J].Allergy,2015,70(5):540-546.
[7] Anastasilakis AD,Polyzos SA,Makras P,et al.Circulating periostin levels do not differ between postmenopausal women with normal and low bone mass and are not affected by zoledronic acid treatment[J].Horm Metab Res,2014,46(2):145-149.
[8] Thomson NC,Chaudhuri R,Spears M,et al.Serum periostin in smokers and never smokers with asthma[J].Respir Med,2015,109(6):708-715.
[9] Okamoto M,Hoshino T,Kitasato Y,et al.Periostin,a matrix protein,is a novel biomarker for idiopathic interstitial pneumonias.[J].Eur Respir J,2011,37(5):1119-1127.
[10] Lv Y,Wang W,Jia WD,et al.High preoparative levels of serum periostin are associated with poor prognosis in patients with hepatocellular carcinoma after hepatectomy[J].Eur J Surg Oncol,2013,39(10):1129-1135.
[11] Ohta N,Kurakami K,Ishida A,et al.Roles of TGF-beta and periostin in fibrosclerosis in patients with IgG4-related diseases[J].Acta Otolaryngol,2013,133(12):1322-1327.
[12] Gordon ED,Sidhu SS,Wang ZE,et al.A protective role for periostin and TGF-β in IgE-mediated allergy and airway hyperresponsiveness[J].Clin Exp Allergy,2012,42(1):144-155.
[13] Matsusaka M,Kabata H,Fukunaga K,et al.Phenotype of asthma related with high serum periostin levels[J].Allergol Int,2015,64(2):175-180.
[14] Yamaguchi Y,Ono J,Masuoka M,et al.Serum periostin levels are correlated with progressive skin sclerosis in patients with systemic sclerosis[J].Br J Dermatol,2013,168(4):717-725.
[15] Agrawal S,Townley RG.Role of periostin,FENO,IL-13,lebrikzumab,other IL-13 antagonist and dual IL-4/IL-13 antagonist in asthma[J].Expert Opin Biol Ther,2014,14(2):165-181.
[16] Song JS,You JS,Jeong SI,et al.Serum periostin levels correlate with airway hyper-responsiveness to methacholine and mannitol in children with asthma[J].Allergy,2015,70(6):674-681.
[17] Wagener AH,de Nijs SB,Lutter R,et al.External validation of blood eosinophils,FE(NO) and serum periostin as surrogates for sputum eosinophils in asthma[J].Thorax,2015,70(2):115-120.
[18] Izuhara Y,Matsumoto H,Kanemitsu Y,et al.GLCCI1 variant accelerates pulmonary function decline in patients with asthma receiving inhaled corticosteroids[J].Allergy,2014,69(5):668-673.
[19] Kim MA,Shin YS,Pham LD,et al.Adult asthma biomarkers[J].Curr Opin Allergy Clin Immunol,2014,14(1):49-54.
[20] Ingram JL,Kraft M.IL-13 in asthma and allergic disease:asthma phenotypes and targeted therapies[J].J Allergy Clin Immunol,2012,130(4):829-842.
[21] 湛洁谊,卢慧敏,林穗玲.哮喘患儿外周血CD4⁺CD25^nt/hiCD127^lo调节性T细胞的测定及临床意义[J].中国实验诊断学,2016,20(1):78-80.

支气管哮喘患儿血清骨膜蛋白水平变化及其意义

Change of serum periostinlevel in children with bronchial asthma and significance

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	安倍莹, 李亚男, 具杨花, 王莹莹, 程航. 哮喘患儿血清中维生素D3水平对哮喘控制和肺功能的影响及其临床意义[J]. 吉林大学学报(医学版), 2018, 44(05): 1010-1013.
[2]	崔银星, 孔菲, 赵旭, 高普均. O-GlcNAc转移酶在肝细胞癌组织中的表达及其临床意义[J]. 吉林大学学报(医学版), 2017, 43(05): 980-984.
[3]	陈丽燕, 唐颖, 张俐, 斯琴, 许力军. 支气管哮喘患者外周血中白细胞介素22水平的检测及其临床意义[J]. 吉林大学学报(医学版), 2017, 43(02): 349-352.
[4]	武军元, 侯向萍. 新疆地区公共场所从业人员戊型肝炎病毒感染血清学调查分析[J]. 吉林大学学报(医学版), 2016, 42(04): 827-829.
[5]	陈敏，赖天文，招轩娜，吕莹莹，高拯妮，黄丹，刘升明. CHI3L1基因多态性和血清YKL-40水平与支气管哮喘发病的关联性[J]. 吉林大学学报(医学版), 2014, 40(05): 1058-1063.
[6]	孙博文，唐颖，李晓丹，许力军. 支气管哮喘患者外周血中IL-33水平的检测及其在支气管哮喘发病机制中的作用[J]. 吉林大学学报(医学版), 2014, 40(02): 395-398.
[7]	张力文，张云峰，尤海龙，刘丽，尹嘉宁. 长期舌下含服粉尘螨滴剂治疗儿童支气管哮喘的有效性和安全性评价[J]. 吉林大学学报(医学版), 2013, 39(1): 148-151.
[8]	王秀华\|刘丽\|乔红梅\|李亚男\|卢清华\|成焕吉. 特应性和非特应性哮喘患儿血清白细胞介素-10和血浆内皮素-1表达水平的检测及其临床意义[J]. J4, 2012, 38(3): 547-550.
[9]	唐颖\|丛中凰\|李晓丹\|许力军. 布地奈德/福莫特罗粉吸入治疗对支气管哮喘患者肺功能改善作用及血清细胞因子的影响[J]. J4, 2012, 38(1): 131-134.
[10]	张雨\|韦倩\|伊鹏霏. 黄芪对支气管哮喘大鼠支气管肺泡灌洗液及血清中NO、IL-5和炎症细胞的影响[J]. J4, 2011, 37(6): 1033-1036.
[11]	李晓丹\|许力军\|刘超英\|邹奇\|丛中凰\|王满\|张洪泉. 联合雾化吸入治疗急性发作期支气管哮喘患者的效果评价[J]. J4, 2011, 37(6): 1120-1123.
[12]	侯松萍,李立,于倩. 氟替卡松/沙美特罗对哮喘患者外周血单个核细胞中辅助性T细胞亚群及气道炎症的影响[J]. J4, 2011, 37(3): 529-533.
[13]	张艳娜, 于振香, 彭丽萍. 双水平正气道压通气治疗中重度支气管哮喘的疗效评价[J]. J4, 2009, 35(4): 731-734.
[14]	张慧云，王顺兰，林丽艳，林青,贝宁，何韶衡. IL-12刺激肥大细胞IL-13分泌与ERK信号转导通路的关系[J]. J4, 2009, 35(2): 322-325.
[15]	赵轶卓，齐玲，徐辉，井玲. 氟对成纤维细胞和成骨细胞TGF-β和Smad2/3表达的影响[J]. J4, 2006, 32(6): 956-959.