The Expression And Correlation Of Serum DJ-1 And Nrf2 In Acute Exacerbation Of Bronchial Asthma

Objective:To analyse the expression levels of serum DJ-1 and nuclear factor E2-related factor 2（NRF2）in patients with acute exacerbation of bronchial asthma and their relationship with related clinical indexes,to preliminary explore the auxiliary diagnostic value of serum DJ-1 and Nrf2 in acute exacerbation of asthma and the assessment value of the severity of the disease,to provide relevant basis for the diagnosis and treatment of asthma.Methods:A case-control study was used to collect 52 patients with acute exacerbation of bronchial asthma who were hospitalized in the Department of Respiratory and Critical Care Medicine of Gansu Provincial People’s Hospital from October 2021 to October 2022as the observation group.According to the symptoms,signs,mental status,respiratory rate,pulse rate,arterial blood gas,peak expiratory flow rate and other related indexes during the acute attack,the observation group was divided into three groups:mild group（10 cases）,moderate group（26 cases）,severe group（16 cases）（critical patients were not included in this study due to severe disease and could not undergo pulmonary function and Fe NO examination）.And 38 cases without related diseases in the physical examination center of Gansu Provincial People’s Hospital during the same period were randomly selected as the control group.Collection of general data on all study subjects:age,sex,body mass index（BMI）,smoking history.Collection of basic pulmonary function,fractional exhaled nitric oxide（Fe NO）,eosinophil count,lymphocyte count,neutrophil count,platelet count,albu-min,globulin.Expression levels of serum DJ-1 and Nrf2 in the observation group and the control group were detected by enzyme-linked immunosorbent assay（ELISA）and to analyze the differences between the groups.To compare the differences in pulmonary function,Fe NO,eosinophil-to-lymphocyte ratio（ELR）,neutrophil-to-lymphocyte ratio（NLR）,albumin-to-globulin ratio（AGR）,systemic immune-inflammation index（SII）and the correlation of serum DJ-1 and Nrf2 with the above indexes between the observation groups.The receiver operating characteristic（ROC）curve was plotted to assess the predictive diagnostic value of serum DJ-1 and Nrf2 in acute exacerbation of asthma.Results:1.There was no significant difference in age,sex,BMI and smoking history between the observation group and the control group（P>0.05）.2.Expression levels of serum DJ-1 and Nrf2 in the observation group were lower than those in the control group,and the differences were statistically significant（P<0.01）.The differences were statistically significant（P<0.01）when comparing serum DJ-1 and Nrf2 in the four groups:control,mild,moderate and severe.Among them,serum DJ-1 in the control group was higher than in the moderate and severe groups,in the mild group was higher than in the severe group.Serum Nrf2 in the control group was higher than in the moderate and severe groups,in the mild and moderate groups were higher than in the severe group,and the differences were statistically significant（P<0.05）.3.Serum DJ-1 was positively correlated with Nrf2（r=0.604,P<0.01）.4.In the observation group,the differences of FEV₁,FEV₁%Pred,FVC,FEV₁/FVC,ELR,Fe NO,NLR and SII in the mild,moderate and severe groups were statistically significant（P<0.05）.FEV₁,FEV₁%pred and FVC in the severe group were lower than in the mild and moderate groups,FEV₁%pred in the moderate group was lower than in the mild group,FEV₁/FVC in the severe group was lower than in the moderate group,Fe NO in the severe and moderate groups were higher than in the mild group,NLR and SII in the severe group was higher that in the mild group,ELR in the severe group was higher that in the moderate and mild groups,AGR in the mild group was higher than in the moderate and severe groups,the difference were statistically significant（P<0.05）.5.In the observation group,serum DJ-1 was positively correlated with FEV₁,FEV₁%pred,FVC and AGR,with values corresponding to（r=0.496,0.535,0.362,0.380,P<0.01）,negatively correlated with Fe NO,ELR,SII,with values corresponding to（r=-0.339,-0.274,-0.325,P<0.05）,there was no significant correlation with FEV₁/FVC and NLR.In the observation group,Serum Nrf2 was positively correlated with FEV₁,FEV₁%pred,FVC,FEV₁/FVC and AGR,with values corresponding to（r=0.545,0.710,0.385,0.352,0.366,P<0.05）,negatively correlated with Fe NO,ELR,NLR and SII,with values corresponding to（r=-0.432,-0.511,-0.372,-0.378,P<0.01）.6.The results of ROC curve analysis showed that:the area under the curve of DJ-1 was0.838（95%CI:0.759-0.918,P<0.05）,with a sensitivity of 63.5%and specificity of 89.5%.The area under the curve of Nrf2 was 0.856（95%CI:0.782-0.930,P<0.05）,with a sensitivity of69.2%and specificity of 86.8%.Conclusions:1.Serum DJ-1 and Nrf2 have certain predictive diagnostic value for the acute exacerbation of asthma,and have certain guiding significance for assessing the severity of the disease.2.Serum DJ-1 and Nrf2 can reflect the level of inflammation in acute exacerbation of asthma,and may be involved in the formation and development of asthma.