Correlation Analaysis Between Fractional Exhaled Nitric Oxide And Serum IL-1β,IL-9 Levels In Asthma And COPD

Background Asthma is a chronic inflammatory respiratory disease characterized by paroxysmal bronchoconstriction and airway hyperresponsiveness to various stimuli such as viral antigens,allergens and environmental exposure,and can cause shortness of breath and chest tightness.Cough and wheezing.The main feature of chronic obstructive pulmonary disease(COPD)is persistent airway obstruction,which is progressive and irreversible.Since the deterioration of both diseases is related to the state of airway inflammation,it is very important to effectively evaluate the role of airway inflammation in the development of these diseases.Although lung function measurement is the gold standard for the diagnosis of asthma and COPD,it can only reflect the degree of airflow limitation and cannot accurately reflect the nature and severity of airway inflammation.Especially for those with acute exacerbations/acute exacerbations of asthma and COPD,it is necessary to find biomarkers that can accurately monitor airway inflammation,assess the degree of airway inflammation,and predict the progression of the disease.Exhaled nitric oxide(FeNO)as an airway inflammatory biomarker is considered to be a surrogate marker for eosinophilic airway inflammation.In addition,FeNO detection is non-invasive,simple,and repeatable.Previous studies have rarely systematically involved changes in FeNO during acute exacerbations of bronchial asthma and acute exacerbations of COPD.In this clinical study,FeNO was used as the starting point to detect and compare the levels of FeNO and serum IL-1β and IL-9 in patients with acute asthma and AECOPD before and after treatment,and analyzed correlation between FeNO and serum IL-1β,IL-9,lung function.Objective To investigate the relationship between exhaled nitric oxide level(FeNO)and serum IL-1β,IL-9 levels in patients with bronchial asthma and COPD before and after treatment,and to analyze its clinical value in evaluating airway inflammation.Methods From March 2017 to August 2018,30 patients with acute asthmatic bronchial asthma and 30 patients with acute exacerbation of chronic obstructive pulmonary disease were enrolled in the Department of Respiratory Medicine of the First Clinical Hospital affiliated to Yangtze University.All patients with acute exacerbations of bronchial asthma were diagnosed in accordance with the guidelines for the 2016 bronchial asthma prevention guidelines developed by the Chinese Medical Association Respiratory Society and the Global Asthma Prevention Initiative.The diagnosis of all patients with acute exacerbations of chronic obstructive pulmonary disease is consistent with the diagnostic criteria in the 2016 Global Strategy for the Diagnosis,Treatment,and Prevention of Chronic Obstructive Pulmonary Disease.The results of FeNO and lung function were measured.The levels of serum IL-1β and IL-9 were measured by double antibody sandwich enzyme-linked immunosorbent assay(ELISA),and the differences between the indicators were compared.Results(1)The age of the AECOPD group(63.63±8.62 years)was greater than that of the asthma group(50.93±12.33 years),and the difference between the two groups was statistically significant(p<0.05).There were no significant differences in the other gender,height,weight and other general data(P>0.05).(2)FeNO levels,serum IL-1β,IL-9 levels(43.17±18.12 ppb,109.65±36.48pg/ml,97.25±34.44pg/ml)before asthma treatment were significantly higher than after treatment: FeNO levels,serum IL-1β IL-9 levels(25.30±10.61 ppb,35.11±11.29 pg/ml,33.71±11.69 pg/ml)(P<0.05).(3)There was no significant difference in FeNO levels before AECOPD treatment(17.93±6.16 ppb)and FeNO levels after AECOPD treatment(16.77±4.89 ppb)(P>0.05);Serum IL-1β and IL-9 levels(75.68±23.41pg/ml,55.15±17.64pg/ml)before AECOPD treatment were significantly higher than those of serum IL-1β and IL-9 after AECOPD treatment(27.78±8.53pg/ Ml,28.35±8.89 pg/ml)(P<0.05).(4)FeNO levels,serum IL-1β,serum IL-9 levels(43.17±18.12 ppb,109.65±36.4pg/ml,97.25±34.44pg/ml)before asthma treatment were significantly higher than before AECOPD treatment :FeNO,serum IL-1β,serum IL-9 levels(17.93 ± 6.16 ppb 75.68 ± 23.41 pg / ml,55.15 ± 17.64 pg / ml)(P <0.05).(5)FeNO levels and serum IL-1β levels(25.30±10.61 ppb,35.11±11.29pg/ml)in acute asthma exacerbation(after treatment)were higher than FeNO and serum IL-1β levels(16.77±4.89 ppb,27.78±8.53 pg/ml)after COPD treatment(P<0.05);Serum IL-9 levels(33.71±11.69 pg/ml)in acute asthma exacerbation(after treatment)were higher than serum IL-9 levels after AECOPD treatment(28.35±8.89 pg/ml)(P>0.05).(6)The level of FeNO in acute exacerbation(pre-treatment)was positively correlated with serum IL-1β and IL-9 levels(r=0.443,p<0.05,r=0.412,p<0.05),and was negatively correlated with pulmonary function FEV1%Pred,FEV1/ FVC(r=-0.364,p<0.05,r=-0.367,p<0.05);The level of FeNO after acute asthma attack was positively correlated with serum IL-1β and IL-9 levels(r=0.437,p<0.05,r=0.389,p<0.05),and was negatively correlated with pulmonary function FEV1%Pred and FEV1/FVC(r=-0.418,p<0.05,r=-0.396,p<0.05).(7)The level of FeNO before AECOPD treatment was not correlated with serum IL-1β,serum IL-9 level,FEV1%Pred,FEV1/FVC(P>0.05);The level of FeNO after AECOPD treatment was not correlated with serum IL-1β,serum IL-9 level,FEV1%Pred,FEV1/FVC(P>0.05).Conclusion FeNO can predict the risk of acute asthma attacks and assess post-treatment response,and Combined detection of serum IL-1β and IL-9 may be more helpful in judging the degree of airway inflammation,guiding treatment and management in asthma;The levels of serum IL-1β and IL-9 were significantly increased in the acute exacerbation of asthma and COPD,decreased significantly after treatment.This suggests that there may be a common inflammatory mechanism in both diseases;The role of FeNO detection in the acute exacerbation of COPD needs further study.