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Airway Inflammation and Lung Function in Sickle Cell Disease.
Pediatric Allergy, Immunology, and Pulmonology ( IF 0.9 ) Pub Date : 2019-09-17 , DOI: 10.1089/ped.2019.1014
Aliva De 1 , Sabhyata Agrawal 2 , Kerry Morrone 3 , Jinghang Zhang 4 , Nicole L Bjorklund 5 , Deepa Manwani 3 , Deepa Rastogi 2
Affiliation  

Rationale: Asthma is a common comorbid condition in sickle cell disease (SCD). However, obstructive lung disease is prevalent in SCD, independent of a diagnosis of asthma. It is speculated that the heightened state of inflammation in SCD, involving pathways distinct from allergic asthma, may underlie the SCD-specific obstructive disease. Objective: The objective of the study was to compare airway and systemic inflammatory markers between SCD patients with pulmonary manifestations and patients with allergic asthma, and correlate the discriminating inflammatory markers with clinical measures of pulmonary disease. Materials and Methods: In a pilot translational study conducted at the Children's Hospital at Montefiore, 15 patients with SCD, and history of asthma, airway obstruction, or airway hyper-reactivity, and 15 control patients with allergic asthma 6-21 years of age were recruited. Inflammatory markers, including peripheral blood T helper cell subsets, serum and exhaled breath condensate (EBC) cytokines and chemokines of the Th-1/Th-17, Th-2, and monocytic pathways, and serum cysteinyl leukotrienes B4 (LTB4), were quantified, compared between the study groups, and correlated with atopic sensitization, pulmonary function tests, and markers of hemolysis. Results: White blood cells (P < 0.05) and monocytes (P < 0.001) were elevated in the SCD group, while atopic characteristics were higher in the control asthma group. Tumor necrosis factor-alpha (P < 0.01), interferon gamma inducible protein (IP)-10 (P < 0.05), and interleukin-4 (P < 0.01) in serum and monocyte chemotactic protein (MCP)-1 in EBC were higher in the SCD group (P ≤ 0.05). Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) in patients with SCD inversely correlated with serum IP-10 and LTB4 levels. Conclusions: Compared with atopic asthmatic patients, inflammatory markers involving Th-1, Th-2, and monocytic pathways were higher in the SCD group, among which Th-1 measures correlated with pulmonary function deficits.

中文翻译:

镰状细胞病的气道炎症和肺功能。

理由:哮喘是镰状细胞病(SCD)的常见合并症。但是,阻塞性肺疾病在SCD中普遍存在,与哮喘的诊断无关。据推测,SCD中炎症的加剧状态涉及与过敏性哮喘不同的途径,可能是SCD特异性阻塞性疾病的基础。目的:本研究的目的是比较具有肺部表现的SCD患者和过敏性哮喘患者的气道和全身炎症标志物,并将可辨别的炎症标志物与肺部疾病的临床指标相关联。材料和方法:在Montefiore儿童医院进行的一项初步转化研究中,有15名SCD患者以及哮喘,气道阻塞或气道高反应性病史,招募了15名6-21岁的过敏性哮喘对照患者。炎症标志物包括外周血T辅助细胞亚群,Th-1 / Th-17,Th-2和单核细胞途径的血清和呼出气冷凝物(EBC)细胞因子和趋化因子,以及血清半胱氨酰白三烯B4(LTB4)。在研究组之间进行量化,比较,并与特应性致敏,肺功能测试和溶血标记物相关。结果:SCD组白细胞(P <0.05)和单核细胞(P <0.001)升高,而哮喘对照组的特应性特征则较高。血清中的肿瘤坏死因子-α(P <0.01),干扰素γ诱导蛋白(IP)-10(P <0.05)和白细胞介素-4(P <0.01)和EBC中的单核细胞趋化蛋白(MCP)-1较高在SCD组中(P≤0.05)。SCD患者的强制肺活量(FVC)和1秒钟呼气量(FEV1)与血清IP-10和LTB4水平成反比。结论:与特应性哮喘患者相比,SCD组中涉及Th-1,Th-2和单核细胞通路的炎症标志物更高,其中Th-1措施与肺功能缺陷有关。
更新日期:2019-11-01
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