半乳糖凝集素 -3、白细胞介素 35、白细胞介素 17在支气管哮喘病儿血清中的水平及与肺功能的相关性

目的探究半乳糖凝集素 -3(Galectin-3)、白细胞介素 35(IL-35)及白细胞介素 17(IL-17)在支气管哮喘病儿血清中的水平及临床意义。方法选取 2021年 8月至 2022年 8月徐州医科大学附属医院诊治的哮喘病儿 77例，分为轻中度哮喘急性发作组( 40例)及哮喘缓解组( 37例)选择同期徐州医科大学附属医院健康体检儿童 26例为对照组。采用酶联免疫法测定血清 Galectin-3、IL-35、IL-17水平。应用，肺功能仪进行肺功能检查，记录第 1秒用力呼气容积 /1 s用力呼气量预计值百分比(FEV1%)、 1s用力呼气量占用力肺活量比值( FEV1/ FVC)、最大呼气 50%瞬间流量( FEF50%)，最大呼气 75%瞬间流量(FEF75%)指标。结果轻中度急性发作组 Gal-3、IL-17水平分别为( 50.89±7.90)ng/L、(60.95±8.14)ng/L，明显高于缓解组的(33.93±9.49)ng/L、(42.94±6.67)ng/L及对照组的( 24.8±5.84)ng/L、(35.45±8.68)ng/L，差异有统计学意义( P<0.05)。轻中度急性发作组 IL-35水平为( 101.28±9.44)ng/L明显低于缓解组(125.91±7.79)ng/L及对照组(148.83±8.09)ng/L，差异有统计学意义(P<0.05)。轻中度急性发作组 FEV1%、FEV1/FVC水平分别为( 67.22±12.11)%、(67.56±12.60)%明显低于缓解组的( 95.4±10.63)%、(95.58±10.95)%和对照组的( 108.21±10.49)%、(108.9±10.03)%，均差异有统计学意义( P<0.05)FEF50%、FEF75%在轻中度急性发作组分别为( 46.22±11.80)%、(38.42±9.94)%，与缓解组的( 50.11±11.53)%、(42.76±12.39)%比，较，差异无统计学意义( P>0.05)，与对照组( 91.75±12.43)%、(93.84±12.07)%比较差异有统计学意义( P<0.05)。 Gal-3与 IL-17呈正相关( P<0.05)， IL-35与 IL-17呈负相关( P<0.05)， Gal-3、IL-17与 FEV1%、FEV1/FVC、FEF50%、FEF75%呈负相关( P<0.05)， IL-35与 FEV1%、FEV1/FVC、FEF50%、FEF75%呈正相关( P<0. 05)。结论哮喘病儿 Gal-3表达上调， IL-35表达下调，引起 IL-17促表达增强、表达抑制作用减弱， IL-17水平升高从而导致气道炎症加重，可能是轻中度哮喘急性发作的发病机制之一；亦可能是哮喘缓解期部分病儿小气道炎症持续存在的可能机制之一。 Gal-3、IL-35、IL-17水平测定有助于预测轻中度哮喘急性发作风险及指导调整吸入糖皮质激素(ICS)用药。

Serum Gal -3, IL -35 and IL -17 expression levels in children with bronchial asthma and their correlation with lung function

Objective To investigate the serum levels and clinical significance of galectin-3 (Gal-3), interleukin-35 (IL-35) and inter-leukin-17 (IL-17) in children with bronchial asthma.Methods Seventy-seven children with asthma diagnosed and treated inThe Affili-ated Hospital of Xuzhou Medical University from August 2021 to August 2022 were selected and assigned into acute attack group ofmild to moderate asthma (n=40) and asthma remission group (n=37), and 26 healthy children having physical examination in the samehospital during the same period were selected as the control group. The serum levels of Gal-3, IL-35 and IL-17 were measured by en-zyme-linked immunosorbent assay. Pulmonary function apparatus was used for pulmonary function examination to record forced expira-tory volume in 1 second/estimated forced expiratory volume in 1 second (FEV1%), ratio of forced expiratory volume to forced vital ca-pacity in 1 second (FEV1 / FVC), the inspiratory flow rate found at 50% of the inhaled vital capacity (FEF50%) and that found at 75%of the inhaled vital capacity (FEF75%).Results The levels of Gal-3 and IL-17 in acute attack group of mild to moderate asthma were(50.89±7.90) ng/L and (60.95±8.14) ng/L, respectively, which were significantly higher than those in remission group [(33.93±9.49) ng/L, (42.94±6.67) ng/L] and the control group [(24.80±5.84) ng/L, (35.45±8.68) ng/L]; the differences were statistically significant (P< 0.05). The level of IL-35 in acute attack group of mild to moderate asthma was (101.28±9.44) ng/L, which was significantly lower thanthat in the remission group and the control group [(125.91±7.79) ng/L, (148.83±8.09) ng/L, respectively]; the difference was statistically significant (P< 0.05). The levels of FEV1% and FEV1/FVC in acute attack group of mild to moderate asthma were (67.22±12.11) %and (67.56±12.60) %, respectively, which were significantly lower than the remission group [(95.40±10.63) %, (95.58±10.95) %] andthe control group [(108.21±10.49) % , (108.9±10.03)% ]; the differences were statistically significant (P<0.05). The FEF50% andFEF75% in acute attack group of mild to moderate asthma were (46.22±11.80) % and (38.42±9.94) %, respectively, which were not sig-nificantly different from those in the remission group [(50.11±11.53) % , (42.76±12.39) % ] (P>0.05), but were significantly different from those in the control group [(91.75±12.43) %, (93.84±12.07) %] (P<0.05). Gal-3 was positively correlated with IL-17 (P<0.05), IL-35 was negatively correlated with IL-17 (P<0.05), and Gal-3 and IL-17 were negatively correlated with FEV1%, FEV1/FVC, FEF50% and FEF75% (P<0.05), while IL-35 was positively correlated with FEV1%, FEV1/FVC, FEF50% and FEF75% (P<0. 05). Conclu. sions The up-regulated expression of Gal-3 and the down-regulated expression of IL-35 in asthmatic children lead to the enhanced ex-pression of IL-17 and the weakened inhibitory effect of IL-17. The increased level of IL-17 leads to the aggravation of airway inflamma-tion, which may be one of the pathogeneses of acute exacerbation of mild to moderate asthma. It may also be one of the possible mecha-nisms for the persistence of small airway inflammation in some children with asthma in remission. The levels of Gal-3, IL-35 and IL-17 are helpful to predict the risk of acute exacerbation of mild to moderate asthma and guide the adjustment of inhaled corticosteroids (ICS) medication.