Clinical significance of inflammatory cell types and inflammatory cytokines in sputum induced by bronchial asthma in children

doi:10.3969/j.issn.1673-8640.2021.01.014

Abstract

Abstract:

Objective To explore the clinical value of inflammatory cell types and inflammatory cytokines in induced sputum in children with bronchial asthma. Methods Fifty-four children with bronchial asthma were selected as the research objects（study group）,and subdivided into mild asthma group,moderate asthma group,and severe asthma group. Forty-two sex- and age-matched children with bronchopneumonia（without asthma）were selected into control group. The inflammatory cell types,T cell immunoglobulin and mucin-3 （Tim-3） mRNA,and inflammation-related cytokines [interleukin（IL）-2,IL-4,IL-10,IL-13,interferon gamma（IFN-γ）] in induced sputum were detected before and after treatment. Results Before treatment,in the induced sputum,eosinophilratio,lymphocyte ratio,Tim-3 mRNA,IL-4,IL-13,IFN-γ and IFN-γ/IL-10 in the study group were significantly higher than those in the control group（P<0.05）,while the levels of IL-2,IL-10 and Th1/Th2 in the study group were significantly lower than those in the control group（P<0.05）. Children with moderate and severe asthma had higher levels of the percentage of eosinophil,the percentage of neutrophil,the percentage of lymphocyte,Tim-3 mRNA,IL-4,IL-13,IFN-γ and IFN-γ/IL-10 than children with mild asthma and children with bronchopneumonia（P<0.05）,while IL-2,IL-10 and Th1/Th2 in the children with moderate and severe asthma were significantly lower than those in the children with mild asthma and children with bronchopneumonia（P<0.05）. Logistic regression analysis showed that the proportion of eosinophils,Tim-3 mRNA,IFN-γ,IL-10,IFN-γ/IL-10 and Th1/Th2 were independent influencing factors of bronchial asthma in children. Receiver operating characteristic （ROC） curve analysis showed that the percentage of eosinophils,Tim-3 mRNA,IFN-γ,IFN-γ/IL-10 and Th1/Th2 had a certain differential effect on bronchial asthma and bronchial pneumonia in children. Conclusion Abnormal expression of eosinophils,Tim-3 mRNA,IFN-γ,IFN-γ/IL-10 and Th1/Th2 in induced sputum of children with bronchial asthma can help to monitor the disease condition,evaluate the efficacy and discriminatebronchopneumonia in children without asthma.

Key words: Bronchial asthma, Inducedsputum, Inflammatory cytokines, Children

CLC Number:

R446.1

GAO Weixia, QIN Xiaowan, LIU Yang, ZHANG Jing, DING Xianchun. Clinical significance of inflammatory cell types and inflammatory cytokines in sputum induced by bronchial asthma in children[J]. Laboratory Medicine, 2021, 36(1): 69-74.

Figures/Tables 4

References 19

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组别	嗜酸性粒细胞百分比/%	中性粒细胞百分比/%	单核细胞百分比/%	淋巴细胞百分比/%	Tim-3 mRNA	IL-4/（pg/mL）
对照组	8.86±1.39	50.85±8.22	25.94±9.42	10.94±6.35	0.28±0.11	31.96±5.77
研究组	19.22±5.16^*	52.92±13.85	24.45±12.55	19.48±3.94^*	0.63±0.09^*	41.33±9.05^*
轻度哮喘组	10.32±2.61^*	41.63±7.03	34.03±8.44	11.45±2.36	0.34±0.11	23.01±5.02
中度哮喘组	18.64±3.22^*#	67.32±10.28^*#	35.83±6.97	18.42±1.84^*#	0.59±0.07^*#	38.44±5.16^*#
重度哮喘组	24.98±3.24^*#△	72.35±4.00^*#	39.21±2.14	22.38±1.82^*#	0.72±0.10^*#△	42.56±7.65^*#
组别	IL-13/（ng/mL）	IL-2/（pg/mL）	IL-10/（ng/mL）	IFN-γ/（pg/mL）	IFN-γ/IL-10	Th1/Th2
对照组	114.31±18.94	190.94±21.90	221.35±54.88	32.41±8.29	0.15±0.05	6.78±1.09
研究组	140.28±31.85^*	139.12±24.82^*	170.64±41.20^*	49.54±14.63^*	0.31±0.09^*	3.74±0.83^*
轻度哮喘组	99.85±13.94	189.43±16.43	220.81±21.39	39.69±7.08	0.17±0.08	4.58±0.45^*
中度哮喘组	122.85±20.45	140.06±16.53^*#	165.34±20.38^*#	44.87±7.92^*#	0.25±0.11^*#	3.62±0.51^*#
重度哮喘组	148.62±19.35^*#	118.63±17.44^*#	152.97±19.57^*#	51.82±9.15^*#	0.33±0.08^*#△	3.01±0.43^*#△

组别	嗜酸性粒细胞百分比/%	中性粒细胞百分比/%	单核细胞百分比/%	淋巴细胞百分比/%	Tim-3 mRNA	IL-4/（pg/mL）
对照组	8.86±1.39	50.85±8.22	25.94±9.42	10.94±6.35	0.28±0.11	31.96±5.77
研究组	19.22±5.16^*	52.92±13.85	24.45±12.55	19.48±3.94^*	0.63±0.09^*	41.33±9.05^*
轻度哮喘组	10.32±2.61^*	41.63±7.03	34.03±8.44	11.45±2.36	0.34±0.11	23.01±5.02
中度哮喘组	18.64±3.22^*#	67.32±10.28^*#	35.83±6.97	18.42±1.84^*#	0.59±0.07^*#	38.44±5.16^*#
重度哮喘组	24.98±3.24^*#△	72.35±4.00^*#	39.21±2.14	22.38±1.82^*#	0.72±0.10^*#△	42.56±7.65^*#
组别	IL-13/（ng/mL）	IL-2/（pg/mL）	IL-10/（ng/mL）	IFN-γ/（pg/mL）	IFN-γ/IL-10	Th1/Th2
对照组	114.31±18.94	190.94±21.90	221.35±54.88	32.41±8.29	0.15±0.05	6.78±1.09
研究组	140.28±31.85^*	139.12±24.82^*	170.64±41.20^*	49.54±14.63^*	0.31±0.09^*	3.74±0.83^*
轻度哮喘组	99.85±13.94	189.43±16.43	220.81±21.39	39.69±7.08	0.17±0.08	4.58±0.45^*
中度哮喘组	122.85±20.45	140.06±16.53^*#	165.34±20.38^*#	44.87±7.92^*#	0.25±0.11^*#	3.62±0.51^*#
重度哮喘组	148.62±19.35^*#	118.63±17.44^*#	152.97±19.57^*#	51.82±9.15^*#	0.33±0.08^*#△	3.01±0.43^*#△

组别	例数	嗜酸性粒细胞百分比/%	中性粒细胞百分比/%	单核细胞百分比/%	淋巴细胞百分比/%	Tim-3 mRNA	IL-2/（pg/mL）
无效组	6
治疗前		19.69±4.74	50.55±7.04	23.99±13.11	18.03±4.44	0.70±0.10	141.39±30.55
治疗后		16.29±5.44^#	53.25±10.06	22.83±11.26	13.85±4.13^#	0.62±0.09	179.33±49.20^#
有效组	48
治疗前		19.01±5.92	51.86±7.96	24.02±12.26	19.48±3.94	0.73±0.09	139.03±29.94
治疗后		8.02±3.79^*#	53.83±9.26	22.30±10.68	12.39±4.13^#	0.42±0.11^*#	180.63±39.97^#
组别	IL-4/（pg/mL）		IL-10/（ng/L^）	IL-13/（ng/L）	IFN-γ/（pg/mL）	IFN-γ/IL-10	Th1/Th2
无效组
治疗前	40.94±10.11		168.54±53.82	139.15±33.78	49.33±15.98	0.32±0.09	3.62±0.96
治疗后	36.72±9.02^#		217.88±49.68^#	111.76±30.02^#	39.78±16.35^#	0.20±0.05^#	4.92±1.11^#
有效组
治疗前	41.59±9.76		171.39±51.48	141.75±30.96	50.41±14.63	0.34±0.07	3.80±1.07
治疗后	34.19±9.23^#		214.53±43.37^#	114.04±29.89^#	25.38±15.86^*#	0.12±0.04^*#	5.67±1.22^*#

组别	例数	嗜酸性粒细胞百分比/%	中性粒细胞百分比/%	单核细胞百分比/%	淋巴细胞百分比/%	Tim-3 mRNA	IL-2/（pg/mL）
无效组	6
治疗前		19.69±4.74	50.55±7.04	23.99±13.11	18.03±4.44	0.70±0.10	141.39±30.55
治疗后		16.29±5.44^#	53.25±10.06	22.83±11.26	13.85±4.13^#	0.62±0.09	179.33±49.20^#
有效组	48
治疗前		19.01±5.92	51.86±7.96	24.02±12.26	19.48±3.94	0.73±0.09	139.03±29.94
治疗后		8.02±3.79^*#	53.83±9.26	22.30±10.68	12.39±4.13^#	0.42±0.11^*#	180.63±39.97^#
组别	IL-4/（pg/mL）		IL-10/（ng/L^）	IL-13/（ng/L）	IFN-γ/（pg/mL）	IFN-γ/IL-10	Th1/Th2
无效组
治疗前	40.94±10.11		168.54±53.82	139.15±33.78	49.33±15.98	0.32±0.09	3.62±0.96
治疗后	36.72±9.02^#		217.88±49.68^#	111.76±30.02^#	39.78±16.35^#	0.20±0.05^#	4.92±1.11^#
有效组
治疗前	41.59±9.76		171.39±51.48	141.75±30.96	50.41±14.63	0.34±0.07	3.80±1.07
治疗后	34.19±9.23^#		214.53±43.37^#	114.04±29.89^#	25.38±15.86^*#	0.12±0.04^*#	5.67±1.22^*#

检测指标	敏感性/%	特异性/%	阳性预测值/%	阴性预测值/%	诊断准确率/%	曲线下面积	95%CI
Tim-3 mRNA	73.39	80.51	81.69	77.82	73.15	0.711	0.606~0.822
IFN-γ	74.02	80.93	81.76	78.86	73.92	0.719	0.613~0.825
嗜酸性粒细胞百分比	76.18	82.25	83.60	77.91	76.75	0.737	0.614~0.835
IFN-γ/IL-10	80.32	85.65	87.69	81.25	80.88	0.798	0.701~0.895
Th1/Th2	78.92	83.59	85.97	80.03	79.43	0.784	0.680~0.888