A Preliminary Study On The Correlation Between Clinical Traits And T Cell Subtypes In Patients With Bronchial Asthma Based On The Lung-gut Theory

Bronchial asthma(BA),as a common respiratory disease in the world,is a reversible expiratory airflow limitation disease.The main clinical manifestations are repeated episodes of wheezing and shortness of breath,with or without chest tightness or coughing.In China,the prevalence of asthma is as high as 4.2%,and the medical expenses required for long-term treatment of asthma are not a small economic burden on patients.The current immune research on asthma has found the role of Th1/Th2 and Treg/Th17 imbalances in asthma,and the "gut-lung axis" theory proves that the gastrointestinal tract is related to lung diseases.This can be compared with the "lungs" of Chinese medicine.By analogy with the "large intestine",this study is based on the lung and bowel theory to study the influence of factors such as the gastrointestinal tract,asthma control grade,and physical fitness on asthma immune cells.Provide clinical experimental basis for later in-depth research,and provide clinical experimental basis for the treatment of asthma with TCM lung and intestine and separate physical therapy.Aim:This study takes bronchial asthma patients in Dongzhimen Hospital as the research object.From the perspective of the external and internal aspects of the lung and the large intestine,the relationship between asthma and gastrointestinal symptoms is studied,and physical bias,gastrointestinal abnormalities,control staging,etc.Correlation between clinical characteristics and T cell subsets.Provide clinical experimental basis for later in-depth research,and provide experimental basis for TCM lung and intestine simultaneous treatment and separate physical therapy.Method:A total of 54 asthma cases and 20 healthy volunteers were enrolled from November 2019 to January 2021.After signing the informed consent of the subjects,10 ml of peripheral blood was collected and left standing at room temperature.After routine isolation of PBMC,Flow cytometry was used to detect the phenotype of peripheral blood immune cells,including the number and proportion of Th1,Th2,Th17,and Treg.And collect general clinical information,disease,gastrointestinal tract,body mass chart and other related information,and process and statistically analyze the data.Results:1.The gastrointestinal score of asthmatic patients was significantly higher than that of the healthy group(P<0.05),the ratio of eosinophils and eosinophils were significantly higher than that of the healthy group(P<0.05),and Th1,Th2,and Th2 in immune cells Th17 values were extremely significantly higher than those in the healthy group(P<0.01),and Treg/Th17 were significantly lower than those in the normal group(P<0.05).2.Asthma patients with normal stool(group C)had significantly higher gastrointestinal scores than healthy people with normal stool(group A)(P<0.05),and asthma patients with abnormal stools(group D)had a significantly higher gastrointestinal score For asthma patients with normal stools(group C)(P<0.01).The white blood cells and neutrophils of the normal stool group(group A and C)were significantly increased in the abnormal stool group(group B and D)(P<0.05).Compared with healthy people with abnormal stools(group B),asthma patients with abnormal stools(group D)had significantly higher Thl,Th1/Th2(P<0.05),significantly higher Th17(P<0.05),and Treg/Th17 Very significantly decreased(P<0.01).3.Compared with the asthma group without allergic rhinitis(group B),the asthma group with allergic rhinitis(group C)had heavier gastrointestinal symptoms(P<0.05),and eosinophils were significantly increased(P<0.01),IL-8 was significantly increased(P<0.05),but there was no significant difference in T cell subsets between the two groups(P>0.05).Enrichment analysis indicated that the functions of regulating cell activation and endocytosis in asthma patients with allergic rhinitis were significantly up-regulated(P<0.05)4.The gastrointestinal score and Th17 of asthmatic patients in the uncontrolled group were significantly increased(P<0.05).5.Among all physiques,the gastrointestinal symptoms of mild asthma were the mildest.In contrast,the gastrointestinal scores of damp-heat,phlegm-dampness,yang deficiency,yin deficiency and blood stasis constitution groups were significantly higher(P<0.05)The Th2 of patients with mild asthma was the lowest,and the gastrointestinal score was the lowest.The Th2 of patients with idiosyncratic,qi deficiency,and yang deficiency was significantly increased(P<0.05);compared with Treg/Th17 of calm constitution,idiosyncratic and yin Deficiency decreased significantly(P<0.05).Conclusion:1.Under the combined effect of gastrointestinal abnormalities and asthma diseases,the gastrointestinal tract score is more serious.Asthma patients’ Th1,Th2,Th17,Treg/Th17 and other related immune factors have also changed significantly.From a clinical point of view,it has been found that the interaction between the intestine and the lungs may be caused by the imbalance of differentiation of T cell subsets.That is,the material basis that causes the two-way effect of the intestinal lung axis is proposed,which may be a subgroup of T cells.2.Asthma patients with allergic rhinitis have significantly increased eosinophils,increased synthesis of inflammatory factors(IL-8),and significantly worsened gastrointestinal clinical symptoms.It is considered that it may act by up-regulating cell activation and endocytosis,causing increased synthesis of inflammatory factors and eosinophils.3.The Th17 and gastrointestinal scores of uncontrolled asthma patients were significantly increased,but the neutrophil ratio was slightly lower.4.Among all physiques,the gastrointestinal symptoms of mild asthmatic patients are the lightest.Compared with them,the gastrointestinal tract scores of damp-heat,phlegm,yang deficiency,yin deficiency,and blood stasis are significantly higher;and In the immunization results,it was found that the Th2 of calm quality was the lowest,while in the intestine-lung axis and physique,Th2 of idiosyncratic,Qi-deficiency,and Yang-deficiency were significantly increased;patients with Yang-deficiency constitution had the lowest CD4 and the highest CD8.