Study Of The Changing Of The Serum IL-13, TGF-β1, VEGF Expressing And The Relationship Between Airway Inflammation And The Remodeling Of Asthma

Aims：To trigger the bronchus asthma attacks of pathological mechanism isalways the hot topics in the study of domestic and foreign scholars,although has made some progress, but because the pathogenesis of complex,up to now, the pathological process was a lack of understanding. More inresearch of cell factors found:"factor network imbalances" in asthma of thedisease may play a crucial role【1】, the imbalance of the factors caused theairway inflammation and remodeling, It is of the most commonpathological changes of asthma.The process guidance by a large number ofcell factors, one of the main factor is the cell "inflammatory cells factor"and "growth cell factors", always view: The inflammation factors onlyparticipate in the airway inflammation, The grow factor only participate inthe airway remodeling process, they are in the process of forming asthmapathology each doing his own job, don’t seem to related; Airwayinflammation occurs to a certain degree, then happen airway remodelling.But now more at home and abroad experimental results hint: both of theairway inflammation factors involved in inflammation, also with many ways in the reshaping of airway process; Growth factor in both thereshaping of airway process, also with many ways in the airwayinflammation. Airway inflammation and reconstituted occur at the sametime, no time difference between. L-13mainly produce by the auxiliary Tcells (TH2), through the activation eosinophil reduce its apoptosis, promotethe IGE secretion mechanism, participate in the maintenance of asthmainflammation【2】, is the key cell factor to produce asthma airwayinflammation; Vascular endothelial growth factor (VEGF) is endothelialcells promote mitotic peptide, in vascular reconstruction and regenerationof action, it is the bronchus asthma airway remodeling of one of importantmedium; Transformation growth factor (TGF-β1) is known as a cause offibrosis of the key role cell factors. So research the expression changes andthe relating of interleukin13(IL-13)、transformation growth factor (TGF-β1)and vascular endothelial growth factor (VEGF) in the bronchus asthmapatients serum, and discusses the relationship of three cell factors withairway inflammation and remodelling, Studying the pathogenesis of asthmamay help for judgment the condition of attacking and treatment of thebronchus asthma.Methods：To choose the asthma patients of acute attacking,36cases (20cases of moderate to severe attacking,16cases of mildattacking), the remission of36cases, the healthy check-up36cases. Taking venous blood early in the morning on an empty stomach, with ELISA method for determining serum IL-13, TGF-β1,VEGF level; All are tried in the lung function testing, and theresults are taking statistical analysis.Results：(1) serum IL-13、TGF-β1、VEGF level analysis: The asthmapatients with acute episode (68.53±13.11) pg/ml have significantly higherlevel in serum IL-13than the remission (40.41±8.19) pg/ml and thecontrol (22.28±2.33) pg/ml, The remission (38.93±2.99) pg/mlsignificantly higher than the control group (22.28±2.33) pg/ml, and thesevere asthma attacks in serum IL-13level (78.81±10.79) pg/ml wassignificantly higher than the mild attacks (60.38±7.66) pg/ml, P <0.01;those of acute episode serum TGF-β1(730.81±129.65) pg/ml significantlyhigher level than the remission (476.07±76.83) pg/ml and the control group(321.03±51.31) pg/ml, the remission (489.68±57.73) pg/ml significantlyhigher than the control group (321.03±51.31)pg/ml, The serum TGF-β1level of the patients with severe asthma (824.03±110.29) pg/ml wassignificantly higher than mild asthma patients (656.23±90.49pg/ml, P <0.01; The acute episode serum VEGF (421.95+/-125.33pg/mlsignificantly higher level remission (214.09±98.79) pg/ml and the controlgroup (99.88±34.75) pg/ml, The remission (204.23±77.01) pg/mlsignificantly higher than the control group(99.88±34.75) pg/ml, in patientswith severe asthma, episode serum VEGF (532.51±102.18) pg/ml level wassignificantly higher than mild asthma patients (333.51±46.59) pg/ml, P < 0.01.(2) pulmonary function analysis: asthma attack period of pulmonaryfunction testing FV1%(50.84±5.43), FEV1/FVC%(65.98±4.65)significantly lower than remission FV1%(86.69±6.1), FEV1/FVC%(75.15±4.17), P <0.01, The remission FV1%(86.68±6.19), FEV1/FVC%(75.15±4.17) significantly lower than those of the control group FEV1%(92.99±3.62), FEV1/FVC%(84.56±4.12), P <0.05, and severe asthmaattack lung function FEV1%(45.96±2.92), FEV1/FVC%(61.67±2.95)significantly lower than mild hair the author FEV1%(54.75±3.95),FEV1/FVC%(69.43±2.18), P <0.01.(3) the correlation analysis: In asthmapatients of attacking and remission serum level of IL-13、TGF-β1andVEGF have a positive correlation between each other (r=0.771, P <0.01; r=0.661, P <0.01; r=0.615, P <0.01),(r=0.652, P <0.01; r=0.731, P <0.01; r=0.623, P <0.01); Asthma patients of acute attacking, serum levelof IL-13, TGF-β1, VEGF and FEV1%is the significant negativecorrelation (r=0.912, p <0.01; r=0.896, p <0.01; r=0.930, p <0.01), noobvious related remission (r=0.195, p>0.05; r=0.170, p>0.05; r=0.020, p>0.05), asthma patients with acute episode serum IL-13, TGF-β1,VEGF and FEV1/FVC%level is a significant negative correlation (r=0.936, p <0.01; r=0.911, p <0.01; r=0.978, p <0.01),Remission have noobvious related (r=0.130, p>0.05; r=0.021, p>0.05; r=0.042, p>0.05).Conclusion:（1）IL-13, TGF-β1, VEGF serum expression level obviously related instructions between the three common cytokine network access,the imbalance is probably one of the main mechanisms of the attack ofasthma; Three of the attack of asthma in each other and influence eachother, promote each other, participation in the asthma and reconstitutedairway inflammation of the pathological process（.2）serum expression levelof IL-13, TGF-β1, VEGF in asthma patients is increasing and dropping atthe same time, It suggests that asthma airway inflammation andreconstituted occur at the same time, no time difference between（.3）IL-1-3,TGF-β1, VEGF expression level in acute asthma with ease in the hair theobvious dynamic change, and with the asthma attack severity is relevant, soso the serum level of three joint test to judge asthma patients in seriouscondition degree, prognosis, auxiliary diagnosis and treatment is ofimportant value. Resistance to IL-13, TGF-β1, VEGF treatment may be thenew target of asthma treatment（.4） the serum IL-13, TGF-β1, VEGF levelof the asthma ease still exist in high expression, It suggests that asthmaease patients there is persistent still airway inflammation and reconstituted,the remission patients still requires treatment.