支气管哮喘患儿血清外泌体miR-93-5p检测的价值

Role of serum exosomal miR-93-5p determination in children with bronchial asthma

目的探讨支气管哮喘患儿血清外泌体微小RNA-93-5p(miR-93-5p)水平检测的价值,及其与气道炎症和肺功能的相关性。方法选取2020年4月—2022年4月内江市第二人民医院支气管哮喘患儿133例(哮喘组)和体检健康儿童133名(正常对照组)。根据支气管哮喘病情将133例患儿分为急性发作期组(51例)和临床缓解期组(82例)。检测所有研究对象血清外泌体miR-93-5p相对表达量、气道炎症指标[血清IgE、白细胞介素(IL)-17、嗜酸性粒细胞绝对数(EO#)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、IL-8]和肺功能[用力肺活量(FVC%)、一秒用力呼气容积(FEV1%)、FEV1占FVC的百分比(FEV1/FVC%)]。采用Pearson相关分析评估各项指标的相关性。采用受试者工作特征(ROC)曲线评价各项指标诊断支气管哮喘患儿急性发作的效能。结果与正常对照组比较,哮喘组血清外泌体miR-93-5p和IgE、IL-17、EO#、CRP、TNF-α、IL-8均升高(P<0.001),FVC%、FEV1%和FEV1/FVC%均降低(P<0.001)。Pearson相关分析结果显示,哮喘组血清外泌体miR-93-5p与IgE、IL-17、EO#、CRP、IL-8均呈正相关(r值分别为0.319、0.440、0.535、0.279、0.296,P<0.05),与FEV1%、FVC%、FEV1/FVC%均呈负相关(r值分别为-0.304、-0.295、-0.327,P<0.05)。与临床缓解期组比较,急性发作期组血清外泌体miR-93-5p相对表达量降低(P<0.001),IgE、IL-17、EO#、CRP、IL-8水平升高(P<0.01)。ROC曲线分析结果显示,血清外泌体miR-93-5p、IgE、IL-17、EO#、CRP、TNF-α、IL-8诊断支气管哮喘急性发作的曲线下面积(AUC)分别为0.88、0.60、0.65、0.64、0.69、0.62、0.66。结论支气管哮喘患儿血清外泌体miR-93-5p水平显著升高,且与患儿肺功能、气道炎症密切相关,或可作为支气管哮喘病情评估的指标。

Objective To investigate the role of serum exosomal microRNA-93-5p(miR-93-5p)determination and its correlation with airway inflammation and lung function in children with bronchial asthma.Methods From April 2020 to April 2022,133 children with bronchial asthma(asthma group)and 133 healthy children(healthy control group)were enrolled from the Second People's Hospital of Neijiang.According to the condition of bronchial asthma,133 children were classified into acute attack group(51 cases)and clinical remission group(82 cases).The relative expression level of serum exosomal miR-93-5p,airway inflammation indicators[serum IgE,interleukin(IL)-17,the absolute value of eosinophils(EO#),C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-α),IL-8]and lung function[forced vital capacity(FVC%),forced expiratory volume in one second(FEV1%)and the percentage of FEV1 in FVC(FEV1/FVC%)]were determined.Pearson correlation analysis was used to evaluate the correlation of each indicator.Receiver operating characteristic(ROC)curve was used to evaluate the indicators'efficiency for the diagnosis of children with bronchial asthma.Results Compared with healthy control group,serum exosomal miR-93-5p,IgE,IL-17,EO#,CRP,TNF-αand IL-8 in asthma group were increased(P<0.001),while FVC%,FEV1% and FEV1/FVC% were decreased(P<0.001).Serum exosomal miR-93-5p was positively correlated with IgE,IL-17,EO#,CRP and IL-8 in asthma group(r values were 0.319,0.440,0.535,0.279 and 0.296,P<0.05).It was negatively correlated with FEV1%,FVC% and FEV1/FVC%(r values were-0.304,-0.295 and-0.327,P<0.05).Compared with clinical remission group,the relative expression level of serum exosomal miR-93-5p in acute attack group was decreased(P<0.001),and the levels of IgE,IL-17,EO#,CRP and IL-8 were increased(P<0.01).The areas under curves(AUC)of serum exosomal miR-93-5p,IgE,IL-17,EO#,CRP,TNF-α and IL-8 in the diagnosis of bronchial asthma were 0.88,0.60,0.65,0.64,0.69,0.62 and 0.66,respectively.Conclusions The level of serum exosomal miR-93-5p is increased in children with bronchial asthma,which is related to lung function and airway inflammation in children,and it may be used as an indicator for the diagnosis and disease severity assessment of bronchial asthma.