| Background：Wheezing in infants is one of the most common respiratory symptoms inchildren all over the world. In recent years, the epidemiological survey data sh-ows that the incidence of wheezing is rising year by year, and wheezing is o-ne of the main reason for seeking medical advice, which severely affect livesand quality of life of children. Due to ateliosis of children’s airway, most patie-nts had frequently breathing after wheezing break attack for the first time, fre-quently breathing is high risk factor that lead to asthma, the incidence of asth-ma in patients with frequently breathing is five to ten times than other patientswithout.With the development of city industrialization and changes on human lifestyle, the morbidity of bronchial asthma presents an upward trend year by year,and bronchial asthma becomes a common chronic respiratory disease, which se-verely damages the health of children and causes a heavy burden to the societ-y and family. There are about300million asthma patients around the world, a-nd the childhood is the sensitive period of asthma development.Unfortunately,the pathogenesis of asthmatic disease in infant is not completely understood,wh-at’s more,it is difficult to find reliable indexes to identify the asthma amongwheezing infants.Therefore, exploring the pathogenesis of infantile wheezing di- sease and analyzing the relationship between bronchial asthma and infant whee-zing, exploring reliable indicators for diagnosis of infants asthma in an early s-tage and finding out the wheezing patients with the tendency to asthma, givin-g early intervention and treatment to prevent its further development,which arehelpful to reduce the morbidity of asthma,give correct guidiance to diagnosisand treatment among early infants with asthmatic diseases and improve the infa-nt health level. It is this problem that both domestic and foreign scholars aretrying to solve.At present,most of the domestic and foreign research focus on the pathoge-nesis of childhood asthma, bronchiolitis and asthmatic bronchitis, however,thepathogenesis of the whole group of asthmatic disease in infants is not explicit.In addition, most of the current research focus on correlation of serum immuno-globulin E, eosinophil cationic protein and interleukin-4levels in infants withasthmatic diseases with those in children with asthma. More and more studieshave confirmed that IL-17, TGF-β1and1,25-(OH)2D3play important roles in t-he pathogenesis of children with asthma, bronchiolitis and asthmatic bronchitis,nevertheless,whether they have effect on the whole group of asthmatic diseasein infants,whether they have relationship with childhood asthma, and whether t-hey can be considered as a reliable predictive indexes of childhood asthma,w-hich are not clear right now.Objective：This study was designed to investigate the changes of serum IL-17,TGF-β1and1,25-(OH)2D3in acute exacerbation of infants with asthmatic diseases, non-asthmaticinfants and the normal healthy infants，to compare the different levels of serumIL-17,TGF-β1and1,25-(OH)2D3in different wheezing attacks and hereditarybackground, to explore the effect of IL-17,TGF-β1and1,25-(OH)2D3in thepathogenesis of infants with asthmatic diseases, to observe the relationship betweenthe pathogenesis of asthma and wheeze, then provide a theoretical basis for theprevention and treatment of infants with asthmatic diseases and prediction of theoccurrence of infant asthma.Methods:We randomly selected infants in pediatric inpatients of our hospital fromNovember10,2013to February10,2014. There were61infants with acute exacerbation of wheezing (asthmatic group), excluding some wheezing caused bybronchial foreign body, cardiac asthma, congenital laryngeal stridor, eosinophilicpneumonia and gastroesophageal reflux so on,40cases with lower resporatory tractinfection without wheezing (non-asthmatic group) and35healthy infants (normalcontrol group). All enrolled children were full-term births. There was no statisticaldifference in age and gender among three groups(P>0.05). All the children did not usehormonal drugs and immune inhibitors for four weeks before enrollment, and we hadobtained the informed consent of all enrolled infants’ guardian.Peripheral venousblood samples were collected, after centrifugated,the serum specimens were frozen in-20℃refrigerator. Concentration of IL17, TGF-β1and1,25-(OH)2D3in thosesamples were measured by enzyme linked immunosorbent assay(ELISA).Allexperimental data were analyzed by the SPSS22.0statistical software.Results:（1）Serum level of IL17in acute phase group of asthmatic was higher thannon-asthmatic group and normal control group(P<0.05)；Serum level of TGF-β1and1,25-(OH)2D3in acute phase group of asthmatic were lower than non-asthmatic groupand normal control group(P<0.05)；Serum level of IL-17in non-asthmatic group washigher than normal control group(P<0.05)；Serum level of TGF-β1,1,25-(OH)2D3innon-asthmatic group were lower than normal control group(P<0.05)；（2）Serum level of IL-17in recurrent wheezing group was higher than the firsttime wheezing group (P<0.05)；Serum level of TGF-β1,1,25-(OH)2D3in recurrentwheezing group were lower than the first time wheezing group (P<0.05);（3）Serum level of IL-17in the asthma-high-risk group was higher thannon-asthma-high-risk group (P<0.05)；Serum level of TGF-β1,1,25-(OH)2D3in theasthma-high-risk group were lower than non-asthma-high-risk group (P<0.05);（4）Serum level of IL-17in the asthma-high-risk group was higher than non-asthma-high-risk group in recurrent wheezing group(P<0.05); Serum level ofTGF-β1,1,25-(OH)2D3in the asthma-high-risk group were lower than non-asthma-hi-gh-risk group in recurrent wheezing group(P<0.05).Conclusion:(1) Serum level of IL-17is higher in the acute phase of wheezing infant; serumlevel of TGF-β1,1,25-(OH)2D3are lower in the acute phase of wheezing infant, it suggests IL-17,TGF-β1and1,25-(OH)2D3are involved in the pathogenesis of infantileasthmatic diseases；(2) Serum level of IL-17is the highest in asthma-high-risk associated withrecurrent wheezing group; serum level of TGF-β1,1,25-(OH)2D3are the lowerest inasthma-high-risk associated with recurrent wheezing group，it indicates that thesechildren are more susceptible to develop into asthma, and its immunologicalpathogenesis may be similar to the mechanism of childhood asthma；(3) Detection of serum IL-17, TGF-β1and1,25-(OH)2D3level in the wheezinginfants can be used as an basis of early diagnosis and early intervention for childrenwho will suffer from asthma. |
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