Immigration版 - Review Invite: Annals of Allergy, Asthma & Immunology |
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entitled "Serum soluble CD30 - a marker of airways inflammation in multiple-
trigger wheezers?"
Article Type: Original Article
Background: Imbalance in activation of T-helper cell types 1 (Th1) and 2 (
Th2) may have a link with the development of asthma. Objective: To evaluate
the role of serum soluble markers of Th1- and Th2-lymphocyte activation with
regard to lung function, inflammatory markers, and therapy response in 90
preschool children with multiple-trigger wheeze. Methods: Lung function was
evaluated by determining airways resistance (Rrs5) by impulse oscillometry.
Airways inflammation was assessed by measuring exhaled nitric oxide fraction
. The children were randomized to receive fluticasone propionate (FP) (n=31)
, salmeterol-fluticasone (SFC) (n=30), or salmeterol (SAL) (n=29) for 8
weeks. Serum soluble Th1-lymphocyte antigen sCD26, soluble Th2-lymphocyte
antigen sCD30, interleukins (IL) 4, 10 and 13, and peripheral blood
eosinophils were measured at baseline and after intervention. A marker of
low-grade systemic inflammation, serum high-sensitivity C-reactive protein (
hs-CRP), was
measured at baseline. Results: At baseline, serum sCD26 correlated
positively with age (p=0.008), and negatively with log-transformed sCD30 (p=
0.001) and hs-CRP (p=0.039). In addition to the negative correlation with
sCD26, log-transformed serum sCD30 correlated negatively with age (p=0.004)
and height (p=0.013), correlated positively with Rrs5 z-score (p=0.029), and
was associated with elevated hs-CRP (p=0.027). During the 8-week
intervention, sCD26 concentration increased in the SAL group (p=0.034), and
sCD30 (p=0.029), IL-4 (p=0.003), IL-10 (p=0.042), IL-13 (p=0.041), and blood
eosinophils (p=0.031) decreased in the SFC group. Conclusion: Th2-
activation with the evidence of low-grade systemic inflammation may underlie
pulmonary function abnormality in multiple-trigger wheezers. Inhaled
corticosteroids in combination with long-acting beta2-agonists might have a
synergistic effect on Th2-mediated inflammatory responses. |
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