哮喘患者气道过敏毒素C3a的变化特点
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摘要
目的研究诱导痰中过敏毒素C3a在支气管哮喘发病中的变化特点及临床意义。方法自2006年9月~2007年2月于我院呼吸科门诊和病房就诊的哮喘急性发作期患者共33例,收集其人口学资料、病史及家族史、肺功能数据及诱导痰中C3a水平,进行分析和总结。结果(1)哮喘急性发作期诱导痰中C3a水平[2.24(1.68~5.58)ng/ml]高于治疗后哮喘临床缓解期C3a水平[0.7(0.24~2.31)ng/ml](P<0.01),哮喘临床缓解期C3a水平高于对照组[0.12(0.07~0.39)ng/ml](P<0.05);(2)哮喘急性发作期,诱导痰C3a水平随轻度急性发作[0.25(0.09~0.40)ng/ml]、中度急性发作[2.21(1.16~3.41)ng/ml]、重度急性发作[4.69(2.69~6.59)ng/ml]依次升高,且存在明显差异(P<0.01);(3)哮喘急性发作期组患者诱导痰C3a水平与诱导痰细胞总数呈正相关(r=0.718,P<0.05),嗜酸性粒细胞计数呈正相关(r=0.495,P<0.05),巨噬细胞计数呈正相关(r=0.600,P<0.05)。结论诱导痰C3a水平与哮喘严重程度和局部炎症细胞学分类相关,可能成为重要的临床标志物指导哮喘的治疗。
Objective To investigate the clinical significance of anaphylatoxin C3 a in induced sputum in patients with asthma.Methods The patients with acute exacerbation of asthma treated at our department between September, 2006 and February,2007 were included in the study. The demographic data, medical history, levels of lung function and C3 a levels in induced sputum were assessed. Results A total of 33 patients were included in the study. The level of C3 a in induced sputum was significantly higher in patients with acute exacerbation of asthma(2.24 ng/ml, range 1.68-5.58 ng/ml) than that in patients with asthma remission(0.7 ng/ml, range 0.24- 2.31 ng/ml, P<0.05). Sputum C3 a levels in the remission patients were significantly higher than those in the healthy controls(0.12 ng/ml, range 0.07-0.39 ng/ml, P<0.05). The levels of C3 a in patients with severe exacerbation(4.69 ng/ml, range 2.69- 6.59 ng/ml) were significantly higher than those in patients with mild exacerbation(0.25ng/ml, range 0.09- 0.40 ng/ml) and moderate exacerbation(2.21 ng/ml, range 1.16- 3.41 ng/ml)(P<0.01), and were significantly higher in patients with moderate exacerbation than in those in mild exacerbation(P<0.01). The level of C3 a in induced sputum was positively correlated with the number of total cell count(r=0.718, P<0.05), eosinophils(r=0.495, P<0.05) and macrophages(r=0.600, P<0.05) in patients with acute exacerbation of asthma. Conclusion Induced sputum C3 a level can serve as an important clinical biomarker for clinical asthma management.
Objective To investigate the clinical significance of anaphylatoxin C3 a in induced sputum in patients with asthma.Methods The patients with acute exacerbation of asthma treated at our department between September, 2006 and February,2007 were included in the study. The demographic data, medical history, levels of lung function and C3 a levels in induced sputum were assessed. Results A total of 33 patients were included in the study. The level of C3 a in induced sputum was significantly higher in patients with acute exacerbation of asthma(2.24 ng/ml, range 1.68-5.58 ng/ml) than that in patients with asthma remission(0.7 ng/ml, range 0.24- 2.31 ng/ml, P<0.05). Sputum C3 a levels in the remission patients were significantly higher than those in the healthy controls(0.12 ng/ml, range 0.07-0.39 ng/ml, P<0.05). The levels of C3 a in patients with severe exacerbation(4.69 ng/ml, range 2.69- 6.59 ng/ml) were significantly higher than those in patients with mild exacerbation(0.25ng/ml, range 0.09- 0.40 ng/ml) and moderate exacerbation(2.21 ng/ml, range 1.16- 3.41 ng/ml)(P<0.01), and were significantly higher in patients with moderate exacerbation than in those in mild exacerbation(P<0.01). The level of C3 a in induced sputum was positively correlated with the number of total cell count(r=0.718, P<0.05), eosinophils(r=0.495, P<0.05) and macrophages(r=0.600, P<0.05) in patients with acute exacerbation of asthma. Conclusion Induced sputum C3 a level can serve as an important clinical biomarker for clinical asthma management.
引文
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[8]曾勉,吴健锋,谢灿茂,等.慢性阻塞性肺疾病急性加重期患者规范化痰诱导安全性的初步研究[J].中华结核和呼吸杂志,2005,28(4):238-41.
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[12]Thangam EB,Venkatesha RT,Zaidi AK,et al.Airway smooth muscle cells enhance C3a-induced mast cell degranulation following cell-cell contact[J].FASEB J,2005,19(7):798-800.
[13]Fregonese L,Swan FJ,van Schadewijk A,et al.Expression of the anaphylatoxin receptors C3a R and C5a R is increased in fatal asthma[J].J Allergy Clin Immunol,2005,115(6):1148-54.
[14]Mathieu MC,Sawyer N,Greig GM,et al.The C3a receptor antagonist SB 290157 has agonist activity[J].Immunol Lett,2005,100(2):139-45.
[15]Lim J,Iyer A,Suen JY,et al.C5a R and C3a R antagonists each inhibit diet-induced obesity,metabolic dysfunction,and adipocyte and macrophage signaling[J].FASEB J,2013,27(2):822-31.
[2]Zhang X,K?hl J.A complex role for complement in allergic asthma[J].Expert Rev Clin Immunol,2010,6(2):269-77.
[3]Onyemelukwe GC.Complement components in Nigerians with bronchial asthma[J].Ann Allergy,1989,63(4):309-12.
[4]van de Graaf EA,Jansen HM,Bakker MM,et al.ELISA of complement C3a in bronchoalveolar lavage fluid[J].J Immunol Methods,1992,147(2):241-50.
[5]中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(支气管哮喘的定义、诊断、治疗及教育和管理方案)[J].中华内科杂志,2003,16(11):68-73.
[6]Humbles AA,Lu B,Nilsson CA,et al.A role for the C3a anaphylatoxin receptor in the effector phase of asthma[J].Nature,2000,406(6799):998-1001.
[7]Krug N,Tschernig T,Erpenbeck VJ,et al.Complement factors C3a and C5a are increased in bronchoalveolar lavage fluid after segmental allergen provocation in subjects with asthma[J].Am J Respir Crit Care Med,2001,164(10 Pt 1):1841-3.
[8]曾勉,吴健锋,谢灿茂,等.慢性阻塞性肺疾病急性加重期患者规范化痰诱导安全性的初步研究[J].中华结核和呼吸杂志,2005,28(4):238-41.
[9]Clark HW,Reid K,Sim RB.Collections and innate immunity in the lung[J].Microbes Infect,2000,2(3):273-8.
[10]Strunk RC,Eidlen DM,Mason RJ.Pulmonary alveolar type II epithelial cells synthesize and secrete proteins of the classical and alternative complement pathways[J].J Clin Invest,1988,81(5):1419-26.
[11]Ames RS,Li Y,Sarau HM,et al.Molecular cloning and characterization of the human anaphylatoxin C3a receptor[J].J Biol Chem,1996,271(34):20231-4.
[12]Thangam EB,Venkatesha RT,Zaidi AK,et al.Airway smooth muscle cells enhance C3a-induced mast cell degranulation following cell-cell contact[J].FASEB J,2005,19(7):798-800.
[13]Fregonese L,Swan FJ,van Schadewijk A,et al.Expression of the anaphylatoxin receptors C3a R and C5a R is increased in fatal asthma[J].J Allergy Clin Immunol,2005,115(6):1148-54.
[14]Mathieu MC,Sawyer N,Greig GM,et al.The C3a receptor antagonist SB 290157 has agonist activity[J].Immunol Lett,2005,100(2):139-45.
[15]Lim J,Iyer A,Suen JY,et al.C5a R and C3a R antagonists each inhibit diet-induced obesity,metabolic dysfunction,and adipocyte and macrophage signaling[J].FASEB J,2013,27(2):822-31.