支气管哮喘急性发作期患儿外周血microRNA-126和microRNA-1表达的意义

Expressions of plasma microRNA - 126 and microRNA - 1 in children with asthma exacerbation and its clinical significance

目的探讨microRNA-126和microRNA-1在支气管哮喘急性发作期患儿外周血中的表达及其与儿童支气管哮喘发病的关系。方法选取2012年10月至2013年12月在广东医学院附属厚街医院门诊及住院部就诊的48例支气管哮喘急性发作期患儿作为研究对象（哮喘组），同期选取52例体检健康的儿童作为对照（健康对照组），留取外周血标本，通过实时荧光定量PCR（RT-PCR）法检测血浆microRNA-126、microRNA-1的表达水平，酶联免疫吸附双抗夹心法（ELISA）检测白细胞介素-4（IL-4）、干扰素-1（IFN-γ）水平，受试者工作特征（ROC）曲线评价microRNA-126、microRNA-1对儿童支气管哮喘诊断的预测价值。结果哮喘组microRNA-126表达相对含量[7．36（0．96～41．21）]显著高于健康对照组[3．68（0．75～38．91）]（Z=3．135，P=0．038）；哮喘组microRNA-1表达相对含量[2．17（0．18～26．97）]显著低于健康对照组[5．83（0．82～39．62）]（Z=2．156，P=0．045）。哮喘组IL-4水平高于健康对照组[（109．98±74．58）ng／L比（78．50±75．82）ng／L，t=2．122，P=0．036]，而IFN-γ水平低于健康对照组[（70．49±12．03）ng／L比（77．03±17．16）ng／L，t=2．270，P=0．025]。MicroRNA-126、microRNA-1在急性发作期哮喘患儿血浆中的灵敏度和在健康对照组的特异度分别为85．42％（41／48例）、79．17％（38／48例）和78．85％（41／52例）、73．08％（38／52例），其中ROC曲线下面积分别为0．919（95％C10．866-0．973），0．867（95％ CI0．796—0．939）。结论 MicroRNA-126在支气管哮喘急性发作期患儿血浆中表达升高，microRNA-1表达降低，提示二者可作为儿童支气管哮喘诊断的检测指标之一。

Objective To investigate the changes in plasma microRNA - 126 and microRNA - 1 in children with asthma exacerbation and its relationship with bronchial asthma. Methods From October 2012 to December 2013, 48 children with asthma exacerbation from the Outpatient Department and the Inpatient Department in Houjie Hospital Affiliated to Guangdong Medical College were enrolled in the study （asthma group）. Meanwhile, 52 healthy children were selected as the healthy control group. The expression levels of plasma microRNA - 126 and microRNA - 1 were detected by real - time quantitative PCR （ RT - PCR）. The content of interleukin - 4 （ IL - 4 ） and interferon - γ （ IFN - γ ） in plasma was measured by enzyme - linked immunosorbent assay （ ELISA ）. The predictive value of microRNA- 126 and microRNA- 1 in plasma to bronchial asthma was evaluated by receiver operating characteristic （ROC） curve. Results The relative expression levels of plasma microRNA - 126 in the asthma group were upregula- ted compared with those in the healthy control group [7.36 （0.96 -41.21 ） vs 3.68 （0.75 -38.91 ） ,Z = 3. 135 ,P = 0. 038 ], and microRNA - 1 relative expression levels in the asthma group were lower than those of the healthy control group [ 2.17 （0.18 - 26.97 ） vs 5.83 （0.82 - 39.62 ） ,Z = 2. 156,P = 0. 045 ]. The content of IL - 4 in asthma group was higher than those of the control group [ （ 109.98 ± 74.58 ） ng/L vs （78.50 ± 75.82）ng/L, t = 2. 122,P = 0.036] , and the IFN -γ level in the asthma group was lower than those of the heahhy control group [ （70.49 ± 12.03 ） ng/L vs （77.03 ± 17.16） ng/L, t = 2. 270, P = 0. 025 ]. In the plasma of patients with asthma exacerbation, the sensitivity of microRNA - 126 and microRNA - 1 was 85.42% （41/48 cases）and 79.17% （38/48 cases） , respectively. The speci- ficity of microRNA - 126 and microRNA - 1 in healthy controls was 78.85% （41/52 cases） and 73.08% （38/52 ca- ses） ,respectively. The area under ROC curve of microRNA - 126 and microRNA - 1 was 0. 919 （95% CI 0. 866 - 0. 973） ,0. 867 （95% CI 0. 796 - 0. 939）. Conclusions MicroRNA - 126 is significantly elevated in plasma of chil- dren with asthma exacerbation. The plasma levels of microRNA - 1 were significantly downregulated. These results sug- gest that microRNA - 126 and microRNA - 1 may be potential markers for the diagnosis of bronchial asthma.