新型细胞因子白细胞介素-38与小儿过敏性哮喘相关性研究

摘要/Abstract

摘要： 目的探讨新型细胞因子白细胞介素-38（IL-38）与小儿过敏性哮喘的关系与意义。方法选择2018年1月—2022年12月于乌鲁木齐市友谊医院就诊的60例小儿过敏性哮喘患儿作为研究对象,包括急性发作期和慢性持续期,各30例,同时选择同期30例健康小儿作为健康对照组,收集两组诱导痰IL-38水平、呼出气一氧化氮（FeNO）水平、肺功能、儿童哮喘控制测试（C-ACT）等临床资料。结果与健康对照组和慢性持续期组比较,急性发作期组的诱导痰IL-38水平明显降低,差异有统计学意义（P<0.05）。相关性分析显示,在急性发作期组中,诱导痰IL-38水平与FeNO呈显著负相关（P<0.05）,而与诱导痰嗜酸粒细胞、肺功能、C-ACT评分等指标均无相关性（P>0.05）。在慢性持续期组和健康对照组中,诱导痰IL-38水平与各指标之间均无相关性（P>0.05）。多因素Logistic回归分析结果显示,C-ACT评分是小儿过敏性哮喘急性发作的独立影响因素（OR=5.427,95%CI：4.926~6.112）,而IL-38不是小儿过敏性哮喘急性发作的独立影响因素（OR=1.597,95%CI：0.758~1.761）。结论 IL-38可能参与小儿过敏性哮喘过程,但不是小儿过敏性哮喘急性发作的独立影响因素。

关键词: 过敏性哮喘, 白细胞介素-38, 小儿

Abstract: Objective To investigate the relationship and significance of interleukin-38 (IL-38), a new cytokine,with allergic asthma in children. Methods Sixty paediatric allergic asthma patients who attended the paediatric department of Friendship Hospital of Urumqi from January 2018 to December 2022 were selected. At the same time,30 healthy children were selected as the healthy control group. Clinical data such as IL-38 level in induced sputum,exhaled nitric oxide (FeNO),lung function and childhood asthma control test (C-ACT) were collected. Results Compared with the healthy control group and the clinical remission group,the level of IL-38 in induced sputum of the acute attack group was significantly lower(P<0.05). Correlation analysis showed that in the acute exacerbation group, the level of IL-38 in induced sputum was negatively correlated with FeNO (P<0.05), but had no correlation with eosinophils,IgE,lung function, C-ACT score and other indicators(P>0.05). In the clinical remission group and healthy control group,there was no correlation between induced sputum IL-38 level and each index(P>0.05). Multivariate logistic regression analysis showed that the score of Children's Asthma Control Test(C-ACT) was an independent influencing factor for the acute attack of allergic asthma in children(OR= 5.427,95%CI: 4.926~6.112), while IL-38 was not an independent influencing factor for the acute attack of allergic asthma in children(OR= 1.597,95%CI: 0.758~1.761). Conclusion IL-38 may participate in the process of allergic asthma in children,but it is not an independent factor influencing the acute attack of allergic asthma in children.

Key words: allergic asthma, interleukin-38, children

中图分类号:

R725.6

张锐. 新型细胞因子白细胞介素-38与小儿过敏性哮喘相关性研究[J]. 中华养生保健, 2024, 42(11): 46-50.

ZHANG Rui. Study on the Correlation between Novel Cytokine Interleukin-38 and Allergic Asthma in Children[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(11): 46-50.

参考文献

[1] 中华医学会变态反应分会呼吸过敏学组(筹),中华医学会呼吸病学分会哮喘学组.中国过敏性哮喘诊治指南(第一版,2019年)[J].中华内科杂志,2019,58(9):636-655.
[2] 申昆玲.控制哮喘,珍爱生命,执行中国儿童哮喘行动计划[J].中华实用儿科临床杂志,2021,36(6):402-404.
[3] 刘婷婷,齐金蕾,殷菊,等.2008年至2018年中国0~19岁人群哮喘死亡现状及变化趋势分析[J].中华实用儿科临床杂志,2021,36(6):471-475.
[4] 刘璐,刘东海,王燕侠,等.奥马珠单抗治疗儿童中重度难治性过敏性哮喘的研究进展[J].国际呼吸杂志,2021,41(4):291-297.
[5] 钟志娟,王灵,冯小伟,等.奥马珠单抗对儿童难治性过敏性哮喘伴鼻炎的疗效及其外周血tIgE和EOS计数的影响[J].中国免疫学杂志,2022,38(4):469-473.
[6] 徐可叶,蒋雯雯,彭笑,等.IL-1家族新成员IL-36、IL-37和IL-38在炎症性疾病中的作用[J].现代免疫学,2018,38(4):337-341.
[7] HUARD A, DO H N, FRANK A C, et al.IL-38 Ablation Reduces Local Inflammation and Disease Severity in Experimental Autoimmune Encephalomyelitis[J]. The Journal of Immunology,2021,206(5):1058-1066.
[8] LI J M, LU R, ZHANG Y, et al.IL-36α/IL-36RA/IL-38 signaling mediates inflammation and barrier disruption in human corneal epithelial cells under hyperosmotic stress[J]. The Ocular Surface,2021,22(6):163-171.
[9] 裴冰,陈克研,吴腾飞,等.SIRT1/HIF-1α信号通路介导IL-38改善胶原诱导性关节炎大鼠Th17/Treg失衡[J].解剖科学进展,2021,27(2):164-168.
[10] 中华医学会变态反应分会呼吸过敏学组(筹),中华医学会呼吸病学分会哮喘学组.中国过敏性哮喘诊治指南(第一版,2019年)[J].中华内科杂志,2019,58(9):636-655.
[11] 中华医学会呼吸病学分会哮喘学组.支气管哮喘防治指南(2020年版)[J].中华结核和呼吸杂志,2020,43(12):1023-1048.
[12] 高永伟,刘庆,李元霞,等.FeNO、C-ACT、1,25-(OH)_2-VD3在儿童哮喘患儿预后评价中的意义[J].临床肺科杂志,2020,25(12):1872-1876.
[13] MAN C, IDA C, EDMUND Y, et al.Aberrant Expression of Novel Cytokine IL-38 and Regulatory T Lymphocytes in Childhood Asthma[J].Molecules,2016,21(7):E933.
[14] 廖增华,李超乾.白细胞介素-1家族新成员IL-36和IL-38在哮喘作用机制中的研究进展[J].中国呼吸与危重监护杂志,2022,21(6):452-456.
[15] SUN X, HOU T, CHEUNG E, et al.Anti-inflammatory mechanisms of the novel cytokine interleukin-38 in allergic asthma[J]. Cell Mol Immunol,2020,17(6):631-646.
[16] MATSUOKA M, KAWAYAMA T, TOMINAGA M, et al.Attenuated Airway Eosinophilic Inflammations in IL-38 Knockout Mouse Model[J].The Kurume Medical Journal,2018,65:37-46.
[17] VEERDONK F, STOECKMAN A K, WU G, et al.IL-38 binds to the IL-36 receptor and has biological effects on immune cells similar to IL-36 receptor antagonist[J]. Proceedings of the National Academy of Sciences of the United States of America,2012,109(8):3001-3005.
[18] 郑丽颖,耿贺梅,刘运秋,等.下气道呼出气一氧化氮水平对过敏性哮喘的鉴别诊断价值研究[J].实用心脑肺血管病杂志,2021,29(9):63-67.
[19] 吴守业,张余转.支气管哮喘患儿诱导痰嗜酸粒细胞与肺功能及FeNO浓度的关系[J].国际呼吸杂志,2020,40(5):355-358.
[20] 吴丹丹,李晓玲,赵晓红.IL-17、IL-27和FeNO与支气管哮喘儿童肺功能的相关性及其对哮喘诊断的临床价值[J].现代药物与临床,2021,36(1):39-44.
[21] 黄嘉莉,郭灵英,庞丽霞,等.重症哮喘患儿FeNO水平与气道功能的关系及对1年内复发的预测价值[J].中国妇幼保健,2020,35(23):4485-4487.