哮喘患儿外泌体中miR-7b水平及与肺功能的关系

The level of miR-7b in exosomes of children with asthma and its relationship with lung function

目的 探讨哮喘患儿外泌体中微小RNA(miR)-7b水平及与肺功能的关系,并分析miR-7b在评估患者病情中的临床价值。方法 选择2016-2021年该院收治的101例哮喘患儿为研究对象,并根据病情分为急性发作期组(40例)和临床缓解期组(61例),选择同期101例体检健康儿童为对照组。比较3组血清外泌体miR-7b、白细胞介素(IL)-4、IL-6、γ干扰素(IFN-γ)、免疫球蛋白E(IgE)、用力肺活量(FVC)、第一秒用力呼气量(FEV)、FEV/FVC水平。采用相关法分析哮喘患儿miR-7b水平与IL-4、IL-6、IFN-γ、IgE、FVC、FEV、FEV/FVC水平的相关性。比较治疗后哮喘患儿各指标水平变化情况。采用受试者工作特征(ROC)曲线分析miR-7b、IL-4、IL-6、IFN-γ、IgE水平在患儿病情评估中的临床价值。结果 相较于对照组,急性发作期组及临床缓解期组miR-7b、IL-4、IL-6、IgE水平更高(P<0.05),而IFN-γ、FVC、FEV、FEV/FVC水平更低(P<0.05);且相较于临床缓解期组,急性发作期组患儿miR-7b、IL-4、IL-6、IgE水平更高(P<0.05),而IFN-γ、FVC、FEV、FEV/FVC水平更低(P<0.05)。相关性分析结果显示,哮喘患儿miR-7b水平与IL-4、IL-6、IgE水平呈正相关(r=0.345、0.392、0.496,P<0.05),而与IFN-γ、FVC、FEV、FEV/FVC水平呈负相关(r=-0.383、-0.416、-0.452、-0.392,P<0.05)。治疗后,哮喘患儿miR-7b、IL-4、IL-6、IgE水平有所下降,而IFN-γ水平有所上升,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,IL-4、IL-6、IFN-γ、IgE水平评估患者病情的曲线下面积(AUC)均<0.80,而miR-7b及联合检测评估患者病情的AUC均>0.80。结论 哮喘患儿血清外泌体miR-7b水平显著上升,并与患儿炎性反应及肺功能密切相关。miR-7b水平在辅助评估哮喘患儿病情中具有一定临床价值。

Objective To investigate the relationship between the level of microRNA(miR-7 b) in exosomes and lung function in children with asthma, and to analyze the clinical value of miR-7 b in assessing the patient′s condition.Methods A total of 101 children with asthma who were treated in the hospital from 2016 to 2021 were selected as the research subjects, and were divided into acute attack group(40 cases) and clinical remission group(61 cases) according to their conditions.During the same period, 101 healthy children were selected as control group.The levels of serum exosomal miR-7 b, interleukin-4(IL-4),interleukin-6(IL-6),interferon gamma(IFN-γ),immunoglobulin E(IgE),forced vital capacity(FVC),forced expiratory volume in one second(FEV) and FEV/FVC among the three groups were compared.The correlation method was used to analyze the correlation between the level of miR-7 b and the levels of IL-4,IL-6,IFN-γ,IgE,FVC,FEV,and FEV/FVC in children with asthma.The changes of each index level in children with asthma after treatment were compared.Receiver operating characteristic(ROC) curve was used to analysis the clinical value of miR-7 b, IL-4,IL-6,IFN-γ,and IgE levels in evaluating the condition of children.Results Compared with the control group, the levels of miR-7 b, IL-4,IL-6,and IgE in the acute attack group and the clinical remission group were higher(P<0.05),while the levels of IFN-γ,FVC,FEVand FEV/FVC were lower(P<0.05),and compared with the clinical remission group, the acute attack group had higher levels of miR-7 b, IL-4,IL-6 and IgE(P<0.05),while the levels of IFN-γ,FVC,FEV,FEV/FVC were lower(P<0.05).The results of correlation analysis showed that the level of miR-7 b in children with asthma was positively correlated with the levels of IL-4,IL-6,and IgE(r=0.345,0.392,0.496,P<0.05),but negatively correlated with the levels of IFN-γ,FVC,FEV,and FEV/FVC(r=-0.383,-0.416,-0.452,-0.392,P<0.05).After treatment, the levels of miR-7 b, IL-4,IL-6,and IgE in children with asthma decreased, while the level of IFN-γ increased, and the differences were statistically significant(P<0.05).The results of the ROC curve showed that the area under the curve(AUC) of the patient′s condition assessed by the levels of IL-4,IL-6,IFN-γ and IgE alone were all <0.80,while the AUC of the patient′s condition assessed by miR-7 b and combined detection were all greater than 0.80.Conclusion The level of serum exosomal miR-7 b in children with asthma increases significantly, and is closely related to the children′s inflammatory response and lung function.The level of miR-7 b has certain clinical value in assisting the assessment of the condition of children with asthma.