Background Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4^＋ T cells subsets might play a role in asthma. We investigated the relative abundance and activit...Background Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4^＋ T cells subsets might play a role in asthma. We investigated the relative abundance and activities of Thl, Th2, Th17 and CD4^＋CD25^＋ Treg cells in patients with allergic asthma. Methods Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma and 20 healthy donors were enrolled. All patients were allergic to house dust mites. Plasma total IgE, pulmonary function and Asthma Control Questionnaire were assessed. The proportions of peripheral blood Thl, Th2, Th17 and CD4^＋CD25^＋ Treg cells were determined by flow cytometry. The expression of cytokines in plasma and Jn the culture supernatant of peripheral blood mononuclear cells was determined by enzyme linked, immunosorbent assay. Results The frequency of blood Th2 cells and IL-4 levels in plasma and culture supernatant of peripheral blood mononuclear cells were increased in all patients with allergic asthma. The frequency of Th17 cells and the plasma and culture supernatant levels of IL-17 were increased, whereas the frequency of CD4^＋CD25^＋ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. Dermatophagoides pteronyssinus specific IgE levels were positively correlated with the percentage of blood Th2 cells and plasma IL-4 levels. Forced expiratory volume in the first second was negatively correlated with the frequency of Th17 cells and plasma IL-17 levels, and positively correlated with the frequency of Treg cells. However, mean Asthma Control Questionnaire scores were positively correlated with the frequency of Th17 cells and plasma IL-17 levels, and negatively correlated with the frequency of Treg cells. Conclusions Imbalances in Thl/Th2 and Th17/Treg were found in patients with allergic asthma. Furthermore, elevated Th17 cell responses, the absence of Tregs and an imbalance in Th17/Treg levels were associated with moderate to severe asthma.展开更多
目的探讨个体化系统性护理干预对支气管哮喘(简称哮喘)疾病控制效果的影响。方法将69例哮喘急性发作期患者,随机分为对照组33例,观察组36例,对照组运用常规健康教育方法,观察组运用个体化系统性护理干预模式,并延续至院外,两组在干预前...目的探讨个体化系统性护理干预对支气管哮喘(简称哮喘)疾病控制效果的影响。方法将69例哮喘急性发作期患者,随机分为对照组33例,观察组36例,对照组运用常规健康教育方法,观察组运用个体化系统性护理干预模式,并延续至院外,两组在干预前、后均采用哮喘认知水平测试和哮喘控制测试(asthma control test,ACT)问卷评价,比较两组接受不同护理干预前后的差异。结果干预前与干预后3个月相比,对照组患者对哮喘的认知水平差异均无统计学意义(均有P>0.05)。观察组干预后其患者对疾病本质、诱发因素、治疗目标、治疗误区、长期治疗、哮喘日记、气雾剂吸入技术掌握、依从性的认知水平及哮喘控制水平与干预前相比差异均有统计学意义(2值分别为6.11,4.93,10.40,10.59,12.16,4.24,10.88,6.07,17.18,P值分别为0.013,0.026,0.002,0.002,0.014,0.043,0.008,0.018)。结论个体化系统性护理干预,可能优于传统性护理健康宣教,可提高哮喘疾病的控制效果。展开更多
文摘Background Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4^＋ T cells subsets might play a role in asthma. We investigated the relative abundance and activities of Thl, Th2, Th17 and CD4^＋CD25^＋ Treg cells in patients with allergic asthma. Methods Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma and 20 healthy donors were enrolled. All patients were allergic to house dust mites. Plasma total IgE, pulmonary function and Asthma Control Questionnaire were assessed. The proportions of peripheral blood Thl, Th2, Th17 and CD4^＋CD25^＋ Treg cells were determined by flow cytometry. The expression of cytokines in plasma and Jn the culture supernatant of peripheral blood mononuclear cells was determined by enzyme linked, immunosorbent assay. Results The frequency of blood Th2 cells and IL-4 levels in plasma and culture supernatant of peripheral blood mononuclear cells were increased in all patients with allergic asthma. The frequency of Th17 cells and the plasma and culture supernatant levels of IL-17 were increased, whereas the frequency of CD4^＋CD25^＋ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. Dermatophagoides pteronyssinus specific IgE levels were positively correlated with the percentage of blood Th2 cells and plasma IL-4 levels. Forced expiratory volume in the first second was negatively correlated with the frequency of Th17 cells and plasma IL-17 levels, and positively correlated with the frequency of Treg cells. However, mean Asthma Control Questionnaire scores were positively correlated with the frequency of Th17 cells and plasma IL-17 levels, and negatively correlated with the frequency of Treg cells. Conclusions Imbalances in Thl/Th2 and Th17/Treg were found in patients with allergic asthma. Furthermore, elevated Th17 cell responses, the absence of Tregs and an imbalance in Th17/Treg levels were associated with moderate to severe asthma.
文摘目的探讨个体化系统性护理干预对支气管哮喘(简称哮喘)疾病控制效果的影响。方法将69例哮喘急性发作期患者,随机分为对照组33例,观察组36例,对照组运用常规健康教育方法,观察组运用个体化系统性护理干预模式,并延续至院外,两组在干预前、后均采用哮喘认知水平测试和哮喘控制测试(asthma control test,ACT)问卷评价,比较两组接受不同护理干预前后的差异。结果干预前与干预后3个月相比,对照组患者对哮喘的认知水平差异均无统计学意义(均有P>0.05)。观察组干预后其患者对疾病本质、诱发因素、治疗目标、治疗误区、长期治疗、哮喘日记、气雾剂吸入技术掌握、依从性的认知水平及哮喘控制水平与干预前相比差异均有统计学意义(2值分别为6.11,4.93,10.40,10.59,12.16,4.24,10.88,6.07,17.18,P值分别为0.013,0.026,0.002,0.002,0.014,0.043,0.008,0.018)。结论个体化系统性护理干预,可能优于传统性护理健康宣教,可提高哮喘疾病的控制效果。
文摘随着分子免疫学和分子遗传学的发展,人们对支气管哮喘发病机制的研究有了进一步发展。中医学认为,哮喘属于中医哮病范畴,痰阻气道、气机失调为本病的基本病机。现代医学认为TH1/TH2类细胞因子失衡、细胞因子、基质金属蛋白酶(matrix metalloproteinase,MMP)及其组织抑制剂(tissue inhibitor of metalloprotein-ase,TIMP)、遗传学因素、神经调节等在哮喘的发生发展过程中起着重要作用。阐明哮喘的发病机制,能为其治疗提供依据。
