沙美特罗/氟替卡松对支气管哮喘患者血清IL-21与总IgE水平的影响

Effect of Salmeterol/fluticasone on Serum Levels of Interleukin-21 and Total IgE in Asthmatic Patients

目的探讨沙美特罗/氟替卡松干粉吸入剂对哮喘患者血清白细胞介素21(interleukin-21I,L-21)和总免疫球蛋白E(immunoglobulin EI,gE)水平的影响,以及哮喘患者血清IL-21和总IgE水平的相关性。方法收集哮喘急性发作期患者45例(哮喘组),哮喘缓解期患者(急性发作期患者控制急性发作后经沙美特罗/氟替卡松规范吸入治疗3个月达到缓解期后复查)30例(治疗组)和健康志愿者20例(对照组)血清,双抗体夹心法酶联免疫吸附实验检测各组血清IL-21和总IgE蛋白水平。结果哮喘组患者血清IL-21水平明显高于对照组(P<0.05),治疗组IL-21水平明显低于哮喘组(P<0.05),且治疗组和对照组差异无统计学意义。哮喘组和治疗组血清总IgE水平均明显高于对照组(P<0.05),哮喘组和治疗组差异无统计学意义。哮喘组血清IL-21水平和总IgE水平显著负相关(r=-0.32,P<0.05)。结论沙美特罗/氟替卡松规范吸入治疗能降低哮喘患者炎症因子IL-21的水平,可能是其治疗哮喘的重要机制之一。

Objective To investigate the combined effect of salmeteroL/fluticasone （SF） therapy on serum levels of interleukin-21 （ IL-21 ） and total IgE in asthmatics, and to explore the relationship between them in patients with allergic asthma. Methods A total of 95 blood samples were collected and divided into three groups： control group （n = 20） , allergic asthma group （n = 45 ） and treatment group （n=30）. Patients belonging to the treatment group were treated with a combination of 50 p,g salmeterol and 250 μg fluticasone twice daily for three months, and it was found that their asthma symptoms were alleviated. The levels of IL-21 and total IgE in blood were detected by enzyme-linked immunosorbent assay （ELISA）. Results The serum levels of IL-21 in control group, allergic asthma group and treatment group were 17. 19, 21. 99 and 17. 18 pg · mL^-1, respectively. The levels of IL-21 significantly differ from each other between the control group and allergic asthma group （ P〈 0.05 ）. Negative relationship was found between the levels of IL-21 and total serum IgE in allergic asthma group （r=-0.32, P〈 0.05）. In addition, IL-21 level were significantly reduced by SF in treatment group compared to allergic asthma group （P〈 0.05）, while SF did not significantly change total IgE levels （P〈0.05）. Conclusion Our results suggested that combined effect of salmeterol/fluticasone inhalation can reduce levels of IL-21 in asthmatic patients, and it might be one of the important mechanisms for the treatment of asthma.