肥胖哮喘患者痰液MUC1、Muc5ac表达及与气道炎症的关系

Expressions of MUC1 and Muc5ac in sputum of obese asthmatic patients and their correlations with airway inflammation

目的探讨肥胖哮喘患者诱导痰液黏蛋白1(MUC1)、黏蛋白5ac(Muc5ac)表达及与气道炎症的关系。方法回顾性分析收治的100例哮喘患者作为研究对象,根据体质指数(BMI)分为肥胖组(n=61)和非肥胖组(n=39),选取60例同期体检肥胖者为肥胖对照组,60例体重正常者为正常对照组,采用酶联免疫吸附法检测诱导痰液MUC1、Muc5ac水平以及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平,HE染色检测诱导痰嗜酸性粒细胞(Eos)比例,观察4组受试者MUC1、Muc5ac、TNF-α、IL-6、IL-17水平及Eos比例,肥胖组和非肥胖组患者哮喘控制水平比较,分析肥胖哮喘患者诱导痰液MUC1、Muc5ac水平与TNF-α、IL-6、IL-17及Eos比例相关性。结果肥胖组、非肥胖组哮喘患者痰液MUC1、Muc5ac水平均明显高于肥胖对照组、正常对照组(P<0.05),肥胖组哮喘患者高于非肥胖组哮喘患者(P<0.05);肥胖组、非肥胖组哮喘患者血清TNF-α、IL-6、IL-17、痰液Eos水平均明显高于肥胖对照组、正常对照组(P<0.05),肥胖组哮喘患者高于非肥胖组哮喘患者(P<0.05),肥胖对照组患者血清TNF-α、IL-6、IL-17水平高于正常对照组(P<0.05);肥胖组哮喘患者哮喘控制测试(ACT)分数低于非肥胖组哮喘患者(P<0.05),未控制患者比例高于非肥胖组(P<0.05),部分控制患者比例低于非肥胖组(P<0.05);肥胖哮喘患者痰液MUC1、Muc5ac水平与TNF-α、IL-6、IL-17、痰液Eos水平呈正相关(P<0.05)。结论肥胖哮喘患者痰液MUC1、Muc5ac表达升高,有严重气道炎症反应,患者痰液MUC1、Muc5ac表达与气道炎症相关。

Objective To investigate the correlations between induced sputum mucin 1(MUC1)and mucin 5 ac(Muc5 ac)expression and airway inflammation in obese asthmatic patients.Methods A retrospective analysis was conducted on 100 asthmatic patients admitted to our hospital from January 2016 to December 2018.According to body mass index(BMI),they were divided into obese group(n=61)and non-obese group(n=39).Sixty obese patients who underwent physical examination during the same period were selected as obese control group and 60 normal weight patients as normal control group.The levels of MUC1 and Muc5 ac in induced sputum and levels of serum TNF-α,IL-6 and IL-17 were assessed by ELISA.The proportion of eosinophils(Eos)in induced sputum was detected by HE staining.The levels of MUC1,Muc5 ac,TNF-α,IL-6 and IL-17,and the proportion of Eos in the four groups were observed.the control level of asthma in obesity group and non-obesity group was compared,and the correlation between levels of MUC1 and Muc5 ac in induced sputum and the proportions of TNF-α,IL-6,IL-17 and Eos in obese asthmatic patients were analyzed.Results The levels of MUC1 and Muc5 ac in sputum of patients with asthma in obesity group and non-obesity group were significantly higher than those in obesity control group and normal control group(P<0.05),and the incidence of asthma in obesity group was significantly higher than that in non-obesity group(P<0.05).The levels of serum TNF-α,IL-6,IL-17 and sputum Eos of asthmatic patients in obesity group and non-obesity group were significantly higher than those in obesity control group and normal control group(P<0.05);the incidence of asthma in obesity group was significantly higher than that in non-obesity group(P<0.05);and the levels of serum TNF-α,IL-6 and IL-17 in obesity control group were significantly higher than those in normal control group(P<0.05).The asthma control test(ACT)score of the obese group was significantly lower than that of the non-obese group(P<0.05);the proportion of uncontrolled patients was significantly higher than that in the obese group(P<0.05);and the proportion of partially controlled patients was significantly lower than that in the non-obese group(P<0.05).The levels of MUC1 and Muc5 ac in sputum of obese asthmatic patients were significantly positively correlated with the levels of TNF-α,IL-6,IL-17 and level of sputum Eos(P<0.05).Conclusion The expressions of MUC1 and Muc5 ac in sputum of obese asthmatic patients are increased,with severe airway inflammation.The expression of MUC1 and Muc5 ac in sputum of obese asthmatic patients is correlated to airway inflammation.