中性粒细胞型哮喘患儿急性发作期CXCL8、CXCL9与气道炎症的关系研究

Relationship between CXCL8,CXCL9 and airway inflammation in childrenwith neutrophilic asthma during acute attack

目的探讨中性粒细胞型哮喘(NA)患儿急性发作期CXC趋化因子配体(CXCL)8、CXCL9与气道炎症的关系。方法选取2020年11月至2021年11月就诊于该院的235例NA患儿作为研究对象,其中处于急性发作期的患儿138例(急性组),处于临床缓解期的患儿97例(缓解组)。采用肺功能仪测定两组用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1)),计算FEV_(1)占预计值的百分比(FEV_(1)%prep)和FEV_(1)/FVC;采用流式细胞分析仪观察中性粒细胞活化率,比色法测定上清液去甲肾上腺素(NE)活性,硝酸还原比色法测定上清液一氧化氮(NO)水平;酶联免疫吸附试验(ELISA)检测血清白细胞介素(IL)-8、IL-17、IL-10、肿瘤坏死因子α(TNF-α)和CXCL9水平,固相夹心ELISA检测血清CXCL8水平。采用Pearson相关性分析炎症因子、趋化因子与肺功能的关系,以及趋化因子与气道炎症的关系。结果急性组患儿FVC、FEV_(1)、FEV_(1)/FVC和FEV_(1)%prep均明显低于缓解组,差异有统计学意义(P<0.05);急性组患儿中性粒细胞活化率、NE活性和NO水平均明显高于缓解组,差异有统计学意义(P<0.05);急性组患儿IL-8、IL-17、IL-10、TNF-α、CXCL8、CXCL9水平均明显高于缓解组(P<0.05);Pearson相关性显示,趋化因子、炎症因子水平均与患儿肺功能呈负相关,趋化因子与气道炎症呈正相关。结论NA患儿急性发作期CXCL8、CXCL9水平与气道炎症及肺功能有关。

Objective To explore the relationship between CXC chemokine ligand(CXCL)8,CXCL9 and airway inflammation in children with neutrophilic asthma(NA)during acute attack.Methods A total of 235 children with NA treated in the hospital from November 2020 and November 2021 were enrolled in this study,including 138 children in acute attack phase(acute group)and 97 children in clinical remission phase(remission group).Forced vital capacity(FVC)and forced expiratory volume in the first second(FEV_(1))of the two groups were measured by pulmonary function instrument,and the percentage of FEV_(1) in the predicted value(FEV_(1)%prep)and FEV_(1)/FVC were calculated.Neutrophil activation rate was observed by flow cytometry,NE activity in supernatant was determined by colorimetry,and nitrogen oxide(NO)was determined by nitric acid reduction colorimetry.Serum levels of interleukin(IL)-8,IL-17,IL-10,tumor necrosis factorα(TNF-α)and CXCL9 were determined by enzyme-linked immunosorbent assay(ELISA).Serum CXCL8 levels were determined by solid-phase sandwich ELISA.Pearson correlation was used to analyze the relationship between inflammatory factors,chemokines and lung function,as well as the relationship between chemokines and airway inflammation.Results FVC,FEV_(1),FEV_(1)/FVC and FEV_(1)%prep in acute group were significantly lower than those in remission group,with statistical significance(P<0.05).Neutrophil activation rate,NE activity and NO level in acute group were significantly higher than those in remission group,with statistical significance(P<0.05).The levels of IL-8,IL-17,IL-10,TNF-α,CXCL8 and CXCL9 in acute group were significantly higher than those in remission group(P<0.05).Pearson correlation showed that chemokines and inflammatory factors were negatively correlated with lung function,and chemokines were positively correlated with airway inflammation.Conclusion The levels of CXCL8 and CXCL9 are associated with airway inflammation and lung function in children with acute attack of NA.