Abstract: Objective: To analyze the dynamic changes of serum levels of macrophage inflammatory protein-1α (MIP-1α) and interleukin-13 (IL-13) of the patients with severe asthma, and to evaluate their clinical values in judgment of the short-term prognosis in the patients with severe asthma. Methods: A total of 102 patients with asthma were divided into severe asthma group (42 cases of severe asthma) and mild asthma group (60 cases of mild and moderate asthma)according to the degree of asthma; a total of 50 contemporaneous healthy examinees were selected as control group. After follow-up for one year, the patients in severe asthma group were divided into preservation sub-group and recurrence sub-group.The serum levels of MIP-1α, IL-13, interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) of the subjects in three groups were detected before therapy and on the 1st, 3rd,and 7th days after therapy respectively; the pulmonary indexes including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, maximum mid-expiratory flow (MMEF) and peak expiratory flow (PEF) of the subjects in three groups were also detected and compared. The correlations between the serum levels of MIP-1α and IL-13 on the 7th day after therapy and FEV1, MMEF and PEF were confirmed by Pearson linear correlation analysis. The serum levels of IL-13 and MIP-1α of the patients in severe ashma group on the 7th day after therapy were compared between preservation sub-group and recurrence sub-group, the relationships between the clinical indexes mentioned above and the recurrence rate of the patients after 1-year follow-up were confirmed by multivariate Logistic analysis,and the diagnostic values of the serum levels of MIP-1α and IL-13 in the recurrence of the patients with severe asthma were analyzed by receiver operating characteristic (ROC) curves. Results: With the prolongation of therapy time, the serum levels of -6, IL-13, TNF-α, and MIP-1α of the patients in severe asthma group and mild asthma group were decreased (P<0.05), and FEV1, FEV1/FVC, MMEF and PEF of the patients were increased (P<0.05). At the same time point, the serum levels of IL-6, IL-13, TNF-α, and MIP-1α of the patients in severe asthma group were higher than those in mild asthma group(P<0.05) and control group(P<0.05); FEV1, FEV1/FVC, MMEF, and PEF of the patients in severe asthma group were lower than those in mild asthma group(P<0.05) and control group (P<0.05). The Pearson linear correlation analysis results showed that there were negative correlations between serum MIP-1α, IL-13 and FEV1, MMEF, PEF (P<0.05). After 1-year follow-up, the serum levels of IL-13 and MIP-1α in the patients in preservation sub-group in severe asthma group were lower than those in recurrence sub-group (P<0.05). The multivariate Logistic analysis results showed that the differences of serum levels of MIP-1α and IL-13 were the independent risk factors of the recurrence of severe asthma (OR=2.135, P=0.033; OR=2.867, P=0.023). Conclusion: The decreasing degree of the serum levels of MIP-1α and IL-13 can assess the pulmonary function and the recurrence of the patients with severe asthma after 1-year follow-up.

Key words: severe asthma, macrophage inflammatory protein-1α, interleukin-13, prognosis, receiver operating characteristic curve