慢性自发性荨麻疹患者治疗前后外周血TPM4和CFL1的变化及意义

Changes and Significance of Peripheral Blood Tropomyosin-4 and Cofilin-1 in Patients with Chronic Spontaneous Urticaria Before and After Treatment

目的 探讨慢性自发性荨麻疹(CSU)患者治疗前后外周血原肌球蛋白-4(TPM4)和丝切蛋白-1(CFL1)mRNA表达及抗体水平的变化及其临床意义。方法 收集上海市浦东新区人民医院2023年1~6月诊治的60例7日荨麻疹活动评分(UAS7)≥28分的重度CSU患者作为研究对象(以下称之为CSU组),予抗组胺药(咪唑斯汀缓释片)治疗12周后,UAS7<7分为有效组(共41例),UAS7≥7分为无效组(共19例)。另选同期30例健康体检者为对照组。实时荧光定量聚合酶链反应(RT-qPCR)检测外周血TPM4和CFL1 mRNA的表达,酶联免疫吸附测定(ELISA)法检测外周血TPM4和CFL1的抗体水平。比较4组中TPM4和CFL1 mRNA的表达和抗体水平。结果 重度CSU患者外周血中TPM4 mRNA表达及抗体水平均高于对照组,但CFL1均低于对照组。抗组胺药物治疗12周后有效组的TPM4 mRNA表达及抗体水平均下降,差异均有统计学意义(P<0.05),治疗前后外周血中CFL1 mRNA表达及抗体水平差异无统计学意义(P>0.05)。结论 TPM4和CFL1可作为检测重度CSU患者的生物学标记物,TPM4亦可作为评价抗组胺药治疗疗效的指标之一。

Objective In order to explore the changes and their clinical significance of peripheral blood tropomyosin-4(TPM4)and cofilin-1(CFL1)mRNA expression and antibody levels in patients with chronic spontaneous urticaria(CSU)before and after treatment.Methods Sixty patients with severe CSU(urticaria activity score over 7 days(UAS7)≥28)which from Pudong New Area People's Hospital of Shanghai from January to June 2023 were selected,and they were enrolled as the CSU group.After treatment with antihistamines(Mizolastine sustained-release tablets)at week 12,CSU patients were classified into effective(UAS7<7,n=41)and ineffective groups(UAS7≥7,n=19)based on their UAS7 score.Thirty healthy subjects undergoing physical examinations during the same period were selected as the control group.The mRNA expression of TPM4 and CFL1 was detected by quantitative real time polymerase chain reaction(RT-qPCR),and the antibody levels of peripheral blood TPM4 and CFL1 were determined by enzyme-linked immunosorbent assay(ELISA).Then the mRNA and antibody levels of TPM4 and CFL1 in the four groups were compared.Results The expression levels of TPM4 mRNA and antibody levels in the peripheral blood of severe CSU patients were higher than those in the control group,but the expression of CFL1 was lower than that in the control group.After 12 weeks of treatment with antihistamines,the expression levels of TPM4 mRNA and antibody in the effective group decreased significantly,while there were no significant differences in the expression of CFL1 mRNA and antibody in the peripheral blood before and after treatment.Conclusion TPM4 and CFL1 can serve as biological markers for monitoring severe CSU patients,and TPM4 can also be one of the indicators for evaluating the efficacy of antihistamine therapy.