过敏性哮喘诱导痰中高迁移率族蛋白B1、晚期糖基化终产物受体表达与血清总免疫球蛋白E水平的相关性

Correlations between the expressions of high mobility group protein B1 and receptor of advanced glycation end⁃product in induced sputum and serum total immunoglobulin E level in children with allergic asthma

目的检测过敏性哮喘病儿诱导痰中高迁移率族蛋白B1(HMGB1)、晚期糖基化终产物受体(RAGE)表达及血清中免疫球蛋白E(IgE)水平,并探讨过敏性哮喘病儿诱导痰中HMGB1、RAGE表达与血清总IgE水平的相关性。方法选取2015年4月至2018年9月因过敏性哮喘于聊城市第二人民医院免疫专科门诊及病房接受治疗的148例病儿(哮喘组);同期选取136例健康体检儿童作为对照组。采用酶联免疫吸附试验(ELISA)检测两组诱导痰中HMGB1、RAGE表达及血清总IgE水平;检测两组肺功能指标、粒细胞水平;分析哮喘组HMGB1、RAGE、IgE与肺功能指标、粒细胞水平相关性;分析哮喘组诱导痰中HMGB1、RAGE表达与血清总IgE水平相关性;分析影响过敏性哮喘的因素。结果哮喘组诱导痰中HMGB1(273.23±86.39)ng/L、RAGE表达(469.54±121.35)ng/L、血清总IgE水平(557.73±156.87)IU/mL、中性粒细胞(33.46±8.73)%、嗜酸粒细胞(7.48±2.64)%均显著高于对照组[(164.83±49.36)ng/L、(309.43±93.68)ng/L、(271.70±89.43)IU/mL、(25.47±6.14)%、(3.46±1.05)%](P<0.05),第一秒用力呼气量(FEV1)(63.19±8.27)%、用力肺活量(FVC)(65.42±6.93)%、最大呼气峰流速(PEF)(63.54±8.42)%水平均显著低于对照组[(89.38±13.21)%、(94.86±13.47)%、(103.24±14.17)%](P<0.05);过敏性哮喘病儿HMGB1、RAGE、IgE与FEV1、FVC、PEF水平均呈现负相关,与中性粒细胞、嗜酸粒细胞水平均呈现正相关(P<0.05);过敏性哮喘病儿诱导痰中HMGB1、RAGE表达与血清总IgE水平均呈现正相关(r=0.454、0.522,均P<0.05);HMGB1、RAGE、IgE、嗜酸性粒细胞是影响过敏性哮喘发生的危险因素。结论过敏性哮喘病儿诱导痰中HMGB1、RAGE表达与血清总IgE水平均呈现正相关,三者与过敏性哮喘病情密切相关。HMGB1、RAGE、IgE结合肺功能指标、粒细胞水平对评价过敏性哮喘的早期危险性有重要意义。

Objective To detect the expressions of high mobility group protein B1(HMGB1),receptor of advanced glycation end⁃product(RAGE)and level of serum immunoglobulin E(IgE)in induced sputum of sick children with allergic asthma,and to ex⁃plore the correlations between the expressions of HMGB1 and RAGE in induced sputum of children with allergic asthma and serum total IgE level.Methods One hundred and forty⁃eightsick children(asthma group)with allergic asthma who were treated in the Immunology clinic and ward,Liaocheng Second People’s Hospital from April 2015 to September 2018 were enrolled,and 136 healthy childrenwere selected as control group during the same period.The expressions of HMGB1 and RAGE in induced sputum and the level of serum total IgE were detected by enzyme⁃linked immunosorbent assay(ELISA),the pulmonary function index and granulocyte level were measured in both groups,the correlations between HMGB1,RAGE,IgE with lung function and granulocyte level in asthma group were analyzed,the correlations between the expressions of HMGB1 and RAGE in induced sputum and the level of serum total IgE in asthma group were analyzed,the factors affecting allergic asthma were analyzed.Results The levels of HMGB1[(273.23±86.39)ng/L vs.(164.83±49.36)ng/L],RAGE[(469.54±121.35)ng/L vs.(309.43±93.68)ng/L],serum total IgE[(557.73±156.87)IU/mL vs.(271.70±89.43)IU/mL],neutrophils[(33.46±8.73)%vs.(25.47±6.14)%]and eosinophils[(7.48±2.64)%vs.(3.46±1.05)%]in induced sputum of asthma group were significantly higher than those of control group(P<0.05),and the levels of forced expiratory volume in one second(FEV1)[(63.19±8.27)%vs.(89.38±13.21)%],forced vital capacity(FVC)[(65.42±6.93)%vs.(94.86±13.47)%],and peak expiratory flow(PEF)[(63.54±8.42)%vs.(103.24±14.17)%]were significantly lower than those of control group(P<0.05).HMGB1,RAGE,IgE were negatively correlated with FEV1,FVC and PEF levels,and positively correlated with neutrophils and eosinophils levels in children with allergic asthma(P<0.05).The expressions of HMGB1 and RAGE in induced sputum of sick children with allergic asthma were positively correlated with serum total IgE(r=0.454,0.522,P<0.05).HMGB1,RAGE,IgE and neutrophils were risk factors for allergic asthma.Conclusions The expressions of HMGB1 and RAGE in induced sputum of sick children with allergic asthma are positively correlated with the level of serum total IgE,which is closely related to the condition of allergic asthma.HMGB1,RAGE,IgE combined with pulmonary function index and granulocyte level are important for evaluating the early risk of allergic asthma.