摘要
目的探讨外周血microRNA-1(miR-1)与支气管哮喘急性发作的关系,及其在预测支气管哮喘急性发作期患者激素治疗敏感性方面的价值。方法纳入72例支气管哮喘急性发作期患者并作为观察组,其中无吸入性糖皮质激素(无ICS组)患者16例、激素敏感型(SS组)患者45例和激素抵抗型(SR组)患者11例。另外,纳入同期门诊健康体检者30例作为对照组。采用逆转录聚合酶链反应(RT-PCR)检测血清miR-1的表达水平,采用Spearman秩相关分析其与白细胞介素(IL)-5、IL-6、IL-8、肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、免疫球蛋白E(IgE)、呼出气一氧化氮(FeNO)的相关性。受试者工作特征(ROC)曲线评价miR-1诊断支气管哮喘急性发作及预测糖皮质激素治疗敏感性的价值。结果SS组和SR组的miR-1的表达水平低于无ICS组及对照组(P<0.05)。相关分析显示,miR-1与IFN-γ呈正相关,与IL-5、IL-6、IL-8、TNF-α、IgE、FeNO呈负相关(均P<0.01)。ROC曲线分析显示,在诊断支气管哮喘急性发作时,miR-1的曲线下面积(AUC)在所有测试标志物中较高(AUC=0.794,95%CI:0.706~0.882,P<0.001);联合诊断的结果显示,miR-1与IFN-γ联合诊断的效能较高(AUC=0.834,95%CI:0.757~0.912,P<0.001)。在对哮喘患者糖皮质激素治疗的敏感性进行预测时,miR-1的预测价值尚可(AUC=0.797,95%CI:0.668~0.926,P=0.002);联合预测结果显示,miR-1联合FeNO的预测价值更高(AUC=0.976,95%CI:0.928~1.000,P<0.001)。结论支气管哮喘患者血清中的miR-1表达水平降低,有可能成为诊断哮喘急性发作的潜在生物标志物;而糖皮质激素抵抗型哮喘患者外周血中的miR-1水平进一步降低,可作为一项预测激素治疗敏感性的指标。
Objective To investigate the relationship between peripheral blood microRNA-1(miR-1) and acute attack of bronchial asthma,and its value in predicting the sensitivity of hormone therapy in patients with acute attack of bronchial asthma.Methods A total of 72 patients with acute exacerbation of bronchial asthma were used as the observation group,including 16 patients without inhaled glucocorticoid(ICS),45 patients with steroid sensitive type(SS),and 11 patients with steroid resistant type(SR).In addition,30 outpatients with health check-ups in the same period were included as the control group.Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the serum expression level of miR-1.The relationship between miR-1,interlenkin(IL)-5,IL-6,IL-8,tumor necrosis factor α(TNF-α),interferon-γ(IFN-γ),immunoglobulin E(IgE),and fractional exhaled nitric oxide(FeNO) was analyzed by using Spearman rank correlation analysis.The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of miR-1 in diagnosing the acute onset of bronchial asthma and the sensitivity of glucocorticoid therapy.Results The expression levels of miR-1 were significantly lower in the SS group and the SR group than those of the ICS-free group and the control group(P<0.05).Spearman rank correlation analysis showed that miR-1 was positively correlated with IFN-γ,and negatively correlated with IL-5,IL-6,IL-8,TNF-α,IgE,and FeNO(all P<0.01).ROC curve analysis showed that in the diagnosis of acute attack of bronchial asthma,the area under the curve(AUC) of miR-1 was higher among all test markers(AUC=0.794,95%CI:0.706-0.882,P<0.001).The results of joint diagnosis showed that the combination of miR-1 and IFN-γ had higher diagnostic efficiency(AUC=0.834,95%CI:0.757-0.912,P<0.001).When predicting glucocorticoid sensitivity in asthmatic patients,the predictive value of miR-1 was fair(AUC=0.797,95%CI:0.668-0.926,P=0.002).The results of combined diagnosis showed that miR-1 combined with FeNO had higher diagnostic va
作者
陈迪
戴标
陈如华
CHEN Di;DAI Biao;CHEN Ru-hua(Department of Pediatrics,Yixing Hospital Affiliated to Jiangsu University,Yixing 214200,China;Department of Respiratory and Critical Care Medicine,Yixing Hospital Affiliated to Jiangsu University,Yixing 214200,China)
出处
《天津医药》
CAS
北大核心
2021年第12期1291-1296,共6页
Tianjin Medical Journal
基金
无锡市卫健委2019年面上项目(MS201938)。
