| ObjectiveAsthma is a reversible airway obstruction, which is characterized by chronic airway inflammation and airway hyper responsiveness. IL-17 and TGF-beta 2 are important pro-inflammatory factors. Airway remodeling is an important feature of asthma. To investigate the expression level changes of interleukin-17 and TGF-beta 2 and the correlation with pulmonary function before and after hormone therapy through the research of blood and induced sputum of asthmatic children in this study. In addition, we want to explore the significance of HRCT in the airway remodeling, and to analyze its relationship with the level of IL-17, TGF-beta 2.Methods30 cases of children diagnosed as bronchial asthma were selected as asthma group (they were treated by regular hormone therapy for six months). In the same period a total of 40 healthy children were selected randomly as normal control group(did not have a history of individual or family allergic disease and other immune diseases, nearly two weeks did not use any drugs, did not suffer from systemic infections in the past one month), carrying out health examination in our hospital child health clinic. 1. The patients with asthma before and after receiving hormone therapy and normal healthy children were treated with venous blood. The expression levels of IL-17 and TGF-beta2 in serum of each group were determined by enzyme linked immunosorbent assay (ELISA) method. At the same time,the lung function of asthmatic children group and normal control group were measured. The detection indicators include:Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), FEV1/FVC ratio, 75%Mid Expiratory Flow (MEF75%),50%Mid Expiratory Flow (MEF50%),25%Mid Expiratory Flow (MEF25%) and Peak Expiratory Flow (PEF). To investigate the expression level changes of interleukin-17 and TGF-beta 2 and the correlation with pulmonary function before and after hormone therapy through the research of blood and induced sputum of asthmatic children. Before and after treatment, the thickness of airway wall was detected by high resolution CT in asthmatic group, and the airway remodeling was assessed.2. According to the literature^ reported, asthmatic patients before and after hormone therapy received induced sputum examination. Collect fresh sputum about lml to microscopy examination. The qualified sputum was mixed an appropriate amount of lysis buffer(0.1%DTT), shock, centrifugal, sediment smear, White Giemsa staining, count and classify cells. Classify the eosinophil cells in induced sputum of asthmatic children before receiving hormone therapy, the asthmatic children were divided into two groups, including eosinophilic asthma (EA)group and non-eosinophilic asthma (NEA)group. Enzyme linked immunosorbent assay(ELISA) was used to determine the content of IL-17 and TGF-beta 2 in induced sputum supernatant. Compare the levels of IL-17 and TGF-beta 2 in induced sputum between EA group and NEA group,those two groups were investigated before and after hormone therapy.Results1. In the asthmatic group, the level of IL-17 in serum before and after hormone therapy was higher than the normal control group, at the same time,the level of before hormone therapy was higher than that after treatment, and the difference was significant, P<0.01.2. In the asthmatic group, the level of TGF-beta 2 in serum before and after hormone therapy was higher than the normal control group, at the same time,the level of before hormone therapy was higher than that after treatment, and the difference was significant, P<0.0\.3.The test index of lung function:FEV1, FVC, FEV1/FVC, MEF75%, MEF50%, MEF25%, PEF in asthmatic children group before treatment were significantly lower than that after treatment and the control group, the difference was significant, P<0.01. Between the asthmatic children group after treatment and the control group, there was no significant difference in FEVI, FVC, FEV1/FVC,PEF, P>0.05; but the difference in MEF75%, MEF50%, MEF25%was still significant,p<0.01.4.To associate IL-17 levels with lung function.our analysis found that the levels of IL-17 in asthmatic children before treatment was negative correlated with lung function(FEVl/FVC,FEVl,FVC,MEF75%,MEF50%,MEF25%,PEF), r were-0.777,-0.490,-0.642,-0.381,-0.523,-0.854,-0.673, PwereO.Ol,<0.01,<0.01,<O.05, <O.01,<0.01,<0.01; the levels of IL-17 after treatment was negative correlated with lung function(FEVl,FVC,MEF50%,MEF25%,PEF), r were-0.679,-0.513,-0.503,-0.430,-0.526, Pwere<0.0K<0.01,<0.01,<0.05,<0.01.5. To associate TGF-beta 2 levels with lung function,our analysis found that the levels of TGF-beta 2 in asthmatic children before treatment was negative correlated with lung function(FEVl/FVC,FEVl,FVC,MEF75%,MEF50%,MEF25%,PEF), r were-0.482,-0.390,-0.495,-0.517,-0.387,-0.475,-0.430, PwereO.01, O.05,<O.05,<0.01, <0.05,<0.01,<0.05; the levels of TGF-beta 2 after treatment was negative correlated with lung function(FVC,MEF25%,PEF), r were-0.395,-0.418,-0.457, P were<0.05, <0.01,<0.05.6.The level of IL-17 in induced sputum:the level of IL-17 in NEA group before treatment was significantly higher than that EA group before and after treatment, NEA after treatment, the difference was significant,p<0.01; but there was no significant difference between EA group before and after treatment, EA before treatment and NEA after treatment, EA after treatment and NEA after treatment,p>0.05.7.The level of TGF-beta 2 in induced sputum:the level of TGF-beta 2 in EA group before treatment was significantly higher than that NEA group before and after treatment, EA after treatment, the difference was significant, P<0.01; but there was no significant difference between NEA group before and after treatment, NEA before treatment and EA after treatment, NEA after treatment and EA after treatment, P>0.05.8.T/D and WA%in bronchial measurement before hormone therapy in asthmatic children, were significantly higher than that after hormone therapy, the difference was statistically significant, P<O.01.9.IL-17 levels in peripheral blood of asthmatic children before treatment and T/D, WA% were no significant correlation, P were> 0.05; there was no significant correlation between TGF-beta 2 and T/D, P> 0.05, but there was a positive correlation with WA%,P=0.029.Conclusionsl.The elevation of IL-17, TGF-beta 2 is an important factor in the pathogenesis of asthma, and it is helpful to the clinical diagnosis of asthma.2.Regular inhaled corticosteroids can inhibit the expression of IL-17 and TGF-beta 2 in asthma.3. The levels of IL-17 and TGF-beta 2 were negatively correlated with lung function, and the correlation between IL-17 levels and lung function was more prominent than that of TGF-beta 2.4. The expression level of IL-17 and TGF-beta 2 was closely related to the airway inflammatory phenotype in asthma.5. Detection of bronchial wall thickness in children with asthma by high resolution CT, which is helpful in assessing airway remodeling. |
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