奥马珠单抗在咳嗽变异性哮喘患者中的应用及对TLR4-WNT-5A信号通路的调控机制探讨

Application of Omalizumab in Patients with Cough Variant Asthma and Its Regulatory Mechanism on TLR4-WNT-5A Signaling Pathway

目的探讨奥马珠单抗在咳嗽变异性哮喘(CVA)患者中应用及对Toll样受体4(TLR4)-分泌性糖蛋白WNT-5A信号通路的调控机制。方法选取2022年1月至2023年12月濮阳市安阳地区医院收治的98例CVA患者,随机分为参照组、研究组,各48例。参照组接受常规治疗,研究组基于参照组接受奥马珠单抗,持续治疗3个月。统计并比较两组哮喘控制率、不良反应及治疗前后TLR4-WNT-5A信号通路相关mRNA、蛋白、肺功能指标[第1 s用力呼气容积占预计值百分比(FEV_(1)%)、用力呼气25%流速(PEF25%)]。结果研究组患者的哮喘总控制率较参照组高,差异有统计学意义(P<0.05);治疗3个月后研究组患者的TLR4 mRNA、TLR4蛋白、WNT-5A mRNA、WNT-5A蛋白水平低于参照组,差异有统计学意义(P<0.05);治疗3个月后研究组患者的FEV_(1)%、PEF25%水平高于参照组,差异有统计学意义(P<0.05);两组不良反应总发生率相比,差异无统计学意义(P>0.05)。结论奥马珠单抗治疗能提高CVA患者肺功能,抑制TLR4-WNT-5A通路活化及炎症因子表达,改善患者生活质量,安全有效。

Objective To explore the application of omalizumab in patients with cough variant asthma(CVA)and its regulatory mechanism on the Toll-like receptor 4(TLR4)-secreted glycoprotein WNT-5A signaling pathway.Methods A total of 98 CVA patients admitted to Anyang District Hospital of Puyang from January 2022 to December 2023 were selected and randomly divided into a reference group and a study group,with 48 cases in each group.The reference group received conventional treatment,while the study group was treated with omalizumab based on the reference group for a continuous period of 3 months.The asthma control rate,adverse reactions,the levels of mRNA,proteins,and lung function indicators related to the TLR4-WNT-5A signaling pathway before and after treatment[percentage of forced expiratory volume in the first second of forced expiratory volume(FEV_(1)%),forced expiratory flow rate at 25%of peak expiratory flow(PEF25%)]were statistically compared between the two groups.Results The total asthma control rate in the study group was significantly higher than that in the reference group(P<0.05).After 3 months of treatment,the levels of TLR4 mRNA,TLR4 protein,WNT-5A mRNA,and WNT-5A protein in the study group were lower than those in the reference group,with statistically significant differences(P<0.05).After 3 months of treatment,the levels of FEV_(1)%and PEF25%in the study group were higher than those in the reference group,with statistically significant differences(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Omalizumab combined with antibiotic therapy can alleviate lung function in CVA patients,inhibit the activation of the TLR4-WNT-5A pathway and the expression of inflammatory factors,improve patients’quality of life,and is safe and effective.