变应性鼻炎患者鼻黏膜组织的miR-223表达水平及其临床意义

The expression level of miR-223 in the nasal mucosa of patients with allergic rhinitis and its clinical significance

目的探讨变应性鼻炎(AR)患者鼻黏膜组织的miR-223表达水平及其临床意义。方法选取2019年1月~2020年12月我院耳鼻喉科收治的变应性鼻炎患者35例作为AR组,同期选择非变应性鼻炎患者35例作为对照组,获取其鼻粘膜组织,并采用实时荧光逆转录法测定两组患者鼻粘膜组织的miR-223水平,同时检测炎症因子TNF-α、IL-6和IL-17水平。对AR组患者的单个鼻部症状评分(INSS)及总鼻部症状评分(TNSS)进行评估。比较两组的miR-223、TNF-α、IL-6、IL-17水平差异,同时分析miR-223对AR的诊断效能及其与患者INSS、TNSS、NF-α、IL-6、IL-17的相关性。结果AR组鼻粘膜组织的miR-223表达水平高于对照组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,鼻黏膜组织的miR-223相对表达量诊断AR的曲线下面积为0.810,截断值为1.56,灵敏度为83.34%,特异度为78.26%。AR组患者的TNF-α、IL-6和IL-17水平均明显高于对照组,差异有统计学意义(P<0.05)。AR患者INSS评分中的流涕为(2.32±0.54)分、鼻痒为(2.16±0.63)分、喷嚏为(2.08±0.42)分、鼻塞为(1.87±0.39)分、TNSS得分为(8.43±2.15)分。其中AR患者鼻黏膜组织的miR-223相对表达量与鼻痒评分、喷嚏评分、鼻塞评分和TNSS均呈正相关(P<0.05),与流涕评分呈负相关(P<0.05)。鼻黏膜组织的miR-223表达水平与AR患者TNF-α、IL-6和IL-17均呈正相关(P<0.05)。结论miR-223在AR患者鼻黏膜组织中异常高表达,对AR具备一定的诊断价值;鼻粘膜组织中的miR-223相对表达水平与AR患病严重程度和炎症因子TNF-α、IL-6、IL-17水平均呈正相关,其有望作为分析AR发病机制及疾病进展的关键指标。

Objective To investigate the expression level of miR-223 in the nasal mucosa of patients with allergic rhinitis(AR)and its clinical significance.Methods A total of 35 patients with allergic rhinitis admitted to our hospital's otolaryngology department from January 2019 to December 2020 were selected as the AR group,and 35 patients with non-allergic rhinitis were selected as the control group during the same period to obtain the nasal mucosa tissue.The real-time fluorescence reverse transcription method was used to determine the miR-223 levels in the nasal mucosa of the two groups of patients,and the levels of inflammatory factors TNF-α,IL-6 and IL-17 were also detected.The single nasal symptom score(INSS)and total nasal symptom score(TNSS)of the AR group were evaluated.The differences in the levels of miR-223,TNF-α,IL-6,and IL-17 were compared between the two groups.At the same time,the diagnostic efficacy of miR-223 for AR and its correlation with patients'INSS,TNSS,NF-α,IL-6,and IL-17 were analyzed.Results The expression level of miR-223 in nasal mucosa tissue of AR group was higher than that of control group,and the difference was statistically significant(P<0.05).ROC curve analysis showed that the relative expression of miR-223 in nasal mucosa tissues diagnosed AR with an area under the curve of 0.810,a cut-off value of 1.56,a sensitivity of 83.34%,and a specificity of 78.26%.The levels of TNF-α,IL-6 and IL-17 in the AR group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).In AR patients’INSS score,runny nose was 2.32±0.54,nasal itching was 2.16±0.63,sneezing was 2.08±0.42,nasal congestion was 1.87±0.39,and TNSS was 8.43±2.15 points.Among them,the relative expression of miR-223 in the nasal mucosa of AR patients was positively correlated with nasal itching score,sneezing score,nasal congestion score and TNSS(P<0.05),and negatively correlated with runny nose score(P<0.05).The expression level of miR-223 in nasal mucosa tissue was positively correlated with TNF-α,IL-6 and IL-17 in AR patients(P<0.05).Conclusion The expression of miR-223 is abnormally high in the nasal mucosa tissue of AR patients,which has certain diagnostic value for AR;the relative expression level of miR-223 in the nasal mucosa tissue is related to the severity of AR and the inflammatory factors TNF-α,IL-6.IL-17 levels are positively correlated,which is expected to be a key indicator for analyzing the pathogenesis and disease progression of AR.