| Objective:In this study,the expression levels of periostin(POSTN),interleukin-13(IL-13),myeloperoxidase(MPO),inflammatory cells and serum immunoglobulin E(Ig E)in induced sputum were detected,so as to analyze the correlation between factors and provide reference for the diagnosis and treatment of severe asthma.Methods:We have selected 36 outpatients who were diagnosed as bronchial asthma and 12 healthy controls during July 2018 to Dec.2019 in Guizhou Provincial People's Hospital as research objects.We record the basic information of all subjects and perform some tests,such as sputum induction,lung function,Fe NO,serum total Ig E test.Asthma Control Test Questionnaire(ACT)was required for asthma patients.Sputum samples were for the cell classification and counting.ELISA was used to detect the levels of POSTN,IL-13,MPO and serum total Ig E in supernatant of induced sputum.Results:1.Comparative analysis of inflammatory cells in induced sputum of three groups:(1)Total cell counts(TCC):the total number of TCC in severe asthma group was significantly higher than mild-moderate asthma group and healthy control group [(5.83±1.28)106/g vs(4.44±1.61)106/g,(3.89±1.29)106/g,P < 0.05],there was no statistically significant difference in the total number of TCC between groups mild-moderate asthma and healthy control;(2)Eosinophil: the proportion of eosinophil decreased gradually in severe asthma group as compared with mild-moderate asthma group and control group(15.76±3.58% vs9.82±2.14%,0.41±0.12%,P<0.05);(3)Neutrophil: the proportion of neutrophil in severe asthma group and mild-moderate asthma group were significantly higher than healthy control group(47.59±4.62% ?46.17±6.61% vs 41.36±2.55%,P<0.05).There was no statistically significant difference in the proportion of neutrophil between groups severe asthma and mild-moderate asthma;(4)Macrophage: the proportion of macrophage increased gradually in severe asthma group as compared with mild-moderate asthma group and control group(34.14±4.04% vs 41.38±4.75%,53.77±2.84%,P < 0.05);(5)Lymphocyte: The difference among severe asthma group,mild-moderate asthma group and healthy control group for the proportion of lymphocyte was not statistically significant(1.72±0.43% vs 1.63±0.36%,1.57±0.32%,P>0.05)2.Comparison of pulmonary function,Fe NO,and ACT among three groups :(1)FEV1:the FEV1 increased gradually in severe asthma group as compared with mild-moderate asthma group and control group[(1.44±0.61)L vs(2.15±0.38)L,(3.04±0.65)L,P<0.05];(2)FEV1%pred:the FEV1%pred increased gradually in severe asthma group as compared with mild-moderate asthma group and control group(54.23±17.54% vs84.73±6.69%,110.93±15.33%,P < 0.05);(3)FEV1/FVC : the FEV1/FVC increased gradually in severe asthma group as compared with mild-moderate asthma group and control group(60.63±11.05% vs 72.56±11.09%,86.22±5.4%,P<0.05);(4)Fe NO:the Fe NO decreased gradually in severe asthma group as compared with mild-moderate asthma group and control group[(78.38±11.54)ppb vs(56.6±9.12)ppb,(11.17±3.33)ppb,P<0.05];(5)ACT:the score of ACT in severe asthma group was lower than mild-moderate asthma group that had significantly difference(12.8±4.1 vs22.0±1.3,P<0.05).3.Comparison of expression levels of phlegm-inflammatory mediators among three groups:(1)The POSTN level decreased gradually in severe asthma group as compared with mild-moderate asthma group and control group[(10.04±3.65)ng/m L vs(2.94±1.26)ng/m L,(0.46±0.2)ng/m L,P<0.05];(2)The IL-13 level decreased gradually in severe asthma group as compared with mild-moderate asthma group and control group[(12.59±1.52 pg/m L vs(6.32±2.13)pg/m L,(4.48±1.76)pg/m L,P<0.05];(3)The MPO level decreased gradually in severe asthma group as compared with mild-moderate asthma group and control group[(12.17±1.7)ng/m L vs(10.6±1.87)ng/m L,(7.89±1.01)ng/m L,P<0.05];(4)the serum total Ig E level decreased gradually in severe asthma group as compared with mild-moderate asthma group and control group[(373.44±41.85)IU/ml vs(208.67±33.32)IU/ml ?(67.27±14.54)IU/ml,P<0.05].4.Correlation analysis:(1)The POSTN had a positive correlation with IL-13,serum total Ig E and EOS%(r=0.635,P<0.01;r=0.759,P<0.01;r=0.468,P<0.01);the IL-13 had a positive correlation with serum total Ig E and EOS%(r=0.781,P<0.01;r=0.940,P<0.01);the MPO had a positive correlation with NEU%(r=0.516,P<0.01),and had no significant correlation with POSTN,IL-13,serum total Ig E and EOS%(P>0.05);(2)The POSTN had a negative correlation with FEV1%pred,FEV1/FVC(r=-0.694,P<0.01;r=-0.578,P<0.01),and had a positive correlation with Fe NO(r=0.479,P<0.05);the IL-13 had a negative correlation with FEV1,FEV1%pred and FEV1/FVC(r=-0.517,P<0.01;r=-0.666,P<0.01;r=-0.434,P<0.01),and had a positive correlation with Fe NO(r=0.622,P<0.01);the MPO had a negative correlation with FEV1(r=-0.473,P<0.01),and had no significant correlation with FEV1%pred,FEV1/FVC and Fe NO(P>0.05);the serum total Ig E had a negative correlation with FEV1,FEV1%pred and FEV1/FVC(r=-0.439,P<0.01;r=-0.808,P<0.01;r=-0.434,P<0.01),and had a positive correlation with Fe NO(r=0.616,P<0.01);(3)EOS% had a negative correlation with FEV1,FEV1%pred and FEV1/FVC(r=-0.540,P<0.01;r=-0.586,P<0.01;r=-0.359,P<0.05),and had a positive correlation with Fe NO(r=0.599,P < 0.01);NEU% had no significant correlation with FEV1,FEV1%pred,FEV1/FVC and Fe NO(P>0.05).Conclusion:1.POSTN,IL-13,MPO in the supernatant of induced sputum and serum total Ig E are involved in the pathogenesis of asthma,and their expression levels are higher in severe asthma patients,suggesting that changes in their expression levels are related to the severity of asthma.2.POSTN in the supernatant of induced sputum can better reflect the severity of asthma,and may become one of the new biomarkers for asthma assessment. |
PDF Full Text Request