摘要
目的探讨糖皮质激素对抵抗性哮喘患者白介素-4(IL-4)、白介素-5(IL-5)的基因水平研究。方法选取2016年7月至2018年7月于本院就诊的哮喘患者56例,其中抵抗性(SR)哮喘28例、敏感性(SD)哮喘28例,选取健康体检者28例为研究对象。采用酶联免疫吸附法(ELISA)测定IL-4、IL-5指标水平变化。采用逆转录-聚合酶链反应(RT-PCR)测定SR哮喘患者外周血单核细胞(PBMCs)中的IL-4mRNA、IL-5mRNA的表达情况。结果SR组、SD组患者治疗前血清IL-4、IL-5水平及其基因表达水平显著高于对照组(P<0.05);SR组、SD组患者治疗后血清IL-4、IL-5水平及其基因表达水平较治疗前降低(P<0.05),且SD组血清IL-4、IL-5水平及其基因表达水平显著低于SR组(P<0.05);SR组、SD组患者治疗后PEF%、FEV 1、FEV 1/FVC指标水平及PEF评分较治疗前降低(P<0.05),且SR组患者肺功能PEF%、FEV 1、FEV 1/FVC指标水平及PEF评分显著低于SD组(P<0.05);SD组患者治疗后每周日间哮喘、每周夜间哮喘发作次数较治疗前降低(P<0.05),且SD组患者治疗后哮喘发作次数显著低于SR组(P<0.05)。结论糖皮质激素SR患者存在IL-5mRNA、IL-4mRNA表达升高,治疗后糖皮质激素SR患者IL-5mRNA、IL-4mRNA仍处于较高水平,IL-5mRNA、IL-4mRNA维持高水平与较差治疗效果有关。
Objective To investigate the study of glucocorticoids on gene levels of interleukin-4(IL-4) and interleukin-5(IL-5) in patients with resistant asthma. Methods 56 asthma patients who were treated in our hospital from July 2016 to July 2018 were selected,including 28 cases of SR asthma and 28 cases of SD asthma. Similarly,28 healthy people were selected for the study. Enzyme-linked immunosorbent assay( ELISA) was used to determine changes in IL-4 and IL-5 levels. The expression of IL-4 mRNA and IL-5 mRNA in peripheral blood mononuclear cells( PBMCs) of patients with SR asthma was determined by RT-PCR. Results The levels of serum IL-4,IL-5 and gene expression in patients with SR and SD before treatment were significantly higher than those in the control group( P < 0. 05). The serum levels of IL-4 and IL-5 and their gene expression levels in the SR and SD groups were lower than before treatment( P < 0. 05),and the serum of the SD group was lower,and the levels of IL-4,IL-5 and their gene expression were significantly lower than those in the SR group( P < 0. 05). After treatment,PEF,FEV1,FEV1/FVC and PEF scores in the SR group and SD group were significantly lower than those before treatment( P <0. 05),and PEF,FEV1,FEV1/FVC and PEF scores in the SR group were significantly lower than those in the SD group( P < 0. 05). The number of asthma and weekly asthma attacks in the SD group was lower than that before treatment( P < 0. 05),and the number of asthma attacks in the SD group was significantly lower than that in the SR group after treatment( P < 0. 05). Conclusion The expression of IL-5 mRNA and IL-4 mRNA in patients with glucocorticoid resistant asthma is increased. After treatment,the levels of IL-5 mRNA and IL-4 mRNA in patients with glucocorticoid resistant asthma are still at a high level. The maintenance of high levels of IL-5 mRNA and IL-4 mRNA is related to poor treatment effect.
作者
姜洁
陈颖
李朋玲
JIANG Jie;CHEN Ying;LI Peng-ling(Department of Respiratory and Critical Care Medicine,The Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu223300,China)
出处
《临床肺科杂志》
2020年第12期1876-1880,共5页
Journal of Clinical Pulmonary Medicine
