目的探讨不同血清25(OH)D3水平哮喘患儿中血清及支气管肺泡灌洗液(BALF)中半乳糖凝集素-3(Gal-3)水平的变化及临床意义。方法选取2013年1月至2014年12月确诊为哮喘的50例患儿为哮喘组,再根据哮喘患儿血清25(OH)D3水平不同分为维生素D适当组(n=7)、不足组(n=12)和缺乏组(n=31);另选同期因气道发育畸形或支气管异物住院的20例患儿为对照组。采用ELISA法检测各组患儿血清25(OH)D3、Gal-3、TIgE及BALF中Gal-3水平。结果哮喘组患儿血清中25(OH)D3水平较对照组低(P<0.05);各组中性粒细胞、嗜酸性粒细胞及上皮细胞计数比较依次为缺乏组>不足组>适当组>对照组(P<0.05);哮喘患儿血清25(OH)D3水平与BALF中中性粒细胞、嗜酸性粒细胞及上皮细胞计数呈负相关(分别r=-0.683、-0.795及-0.670,P<0.05);哮喘患儿血清25(OH)D3水平与血清Gal-3、TIgE水平呈明显负相关(分别r=-0.759、-0.875,P<0.05)。结论哮喘患儿普遍存在维生素D缺乏或不足,25(OH)D3及Gal-3可能参与了哮喘患儿呼吸道炎性反应,与哮喘的发生、发展相关。
Abstract
Objective To investigate the changes of the levels of galectin-3(Gal-3) in serum and bronchoalveolar lavage fluid (BALF) of children with asthma whose have different serum levels of 25-hydroxyl-vitamin D3[25(OH)D3]. Methods Fifty children with asthma between January 2013 and December 2014 were enrolled as the asthma group, and they were classified into 25(OH)D3 sufficient (n=7), insufficient (n=12) and deficient subgroups (n=31) according to the serum levels of 25(OH)D3. Twenty children with abnormal airway or tracheal foreign bodies served as the control group. The levels of 25(OH)D3, Gal-3 and total IgE in serum and Gal-3 levels in BALF were measured using ELISA. Results The serum levels of 25(OH)D3 in the asthma group were lower than in the control group (P<0.05). The 25(OH)D3 deficient subgroup displayed the highest percentages of neutrophils, eosinophils and epithelial cells in BALF, followed by the 25(OH)D3 insufficient subgroup and the 25(OH)D3 sufficient subgroup (P<0.05). The percentages of neutrophils, eosinophils and epithelial cells in BALF in the three subgroups were all higher than in the control group (P<0.05). In children with asthma, serum levels of 25(OH)D3 were negatively correlated with the percentages of neutrophils, eosinophils and epithelial cells in BALF (r=-0.683, -0.795 and -0.670 respectively; P<0.05); and a negative correlation was also seen between serum 25(OH)D3 levels and serum Gal-3 and total IgE levels (r=-0.759 and -0.875 respectively; P<0.05). Conclusions The children with asthma have low serum levels of 25(OH) D3. 25(OH) D3 and Gal-3 may be involved in the airway inflammation and the development of asthma.
关键词
哮喘 /
25-羟维生素D3 /
半乳糖凝集素-3 /
儿童
Key words
Asthma /
25-Hydroxyl-vitamin D3 /
Galectin-3 /
Child
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Iqbal SF, Freishtat RJ. Mechanism of action of vitamin D in the asthmatic lung[J]. J Investig Med, 2011, 59(8):1200-1202.
[2] Saegusa J, Hsu DK, Chen HY, et al. Galectin-3 is critical for the development of the allergic inflammatory response in a mouse model of atopic dermatitis[J]. Am J Pathol, 2009, 174(3):922-931.
[3] Dorsch MP, Nemerovski CW, Ellingrod VL, et al. Vitamin D receptor genetics on extracellular matrix biomarkers and hemodynamics in systolic heart failure[J]. J Cardiovasc Pharmacol Ther, 2014, 19(5):439-445.
[4] Aubin JE, Gupta AK, Bhargava U, et al. Expression and regulation of galectin 3 in rat osteoblastic cells[J]. J Cell Physiol, 1996, 169(3):468-480.
[5] 中华医学会儿科学分会呼吸学组, 《中华儿科杂志》编辑委员会. 儿童支气管哮喘诊断与防治指南[J]. 中华儿科杂志, 2008, 46(10):745-753.
[6] Holick MF. Vitamin D deficiency[J]. N Engl J Med, 2007, 357(3):266-281.
[7] Reichel H, Koeffler HP, Norman AW, et al. The role of the vitamin D endocrine system in health and disease[J]. N Engl J Med, 1989, 320(15):980-991.
[8] Brehm JM, Schuemann B, Fuhlbrigge AL, et al. Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma Management Program study[J]. J Allergy Clin Immunol, 2010, 126(1):52-58.
[9] Martineau AR, Timms PM, Bothamley GH, et al. High-dose vitamin D(3) during intensive-phase antimicrobial treatment of pulmonary tuberculosis:a double-blind randomised controlled trial[J]. Lancet, 2011, 377(9761):242-250.
[10] Uysalol M, Mutlu LC, Saracoglu GV, et al. Childhood asthma and vitamin D deficiency in Turkey:is there cause and effect relationship between them?[J]. Ital J Pediatr, 2013, 39:78.
[11] Bener A, Ehlayel MS, Tulic MK, et al. Vitamin D deficiency as a strong predictor of asthma in children[J]. Int Arch Allergy Immunol, 2012, 157(2):168-175.
[12] 马秀丽, 甄艳芬. 支气管哮喘儿童血清25(OH)D3和总免疫球蛋白E的变化[J]. 中国当代儿科杂志, 2011, 13(7):551-553.
[13] 蒋鲲, 陈和斌, 王莹, 等. IL-17和TGF-β1在支气管哮喘患儿血清及支气管肺泡灌洗液中的变化及临床意义[J]. 中国当代儿科杂志, 2013, 15(8):604-608.
[14] 刘佩意, 陈相, 蒋卓勤, 等. 早期补充维生素D对幼年哮喘大鼠肺组织炎症因子的影响[J]. 中华预防医学杂志, 2011, 45(7):645-649.
[15] Trujillo G, Habiel DM, Ge L, et al. Neutrophil recruitment to the lung in both C5a-and CXCL1-induced alveolitis is impaired in vitamin D-binding protein-deficient mice[J]. J Immunol, 2013, 191(2):848-856.
[16] Hirsch D, Archer FE, Joshi-Kale M, et al. Decreased antiinflammatory responses to vitamin D in neonatal neutrophils[J]. Mediators Inflamm, 2011, 2011:598345.
[17] 蒋鲲, 陈和斌, 王莹, 等. 支气管哮喘患儿血清及支气管肺泡灌洗液中半乳糖凝集素-3和转化生长因子-β1的变化[J]. 临床儿科杂志, 2013, 31(2):113-116.
[18] MacKinnon AC, Farnworth SL, Hodkinson PS, et al. Regulation of alternative macrophage activation by galectin-3[J]. J Immunol, 2008, 180(4):2650-2658.
[19] Fattouh R, Jordana M. TGF-beta, eosinophils and IL-13 in allergic airway remodeling:a critical appraisal with therapeutic considerations[J]. Inflamm Allergy Drug Targets, 2008, 7(4): 224-236.
[20] Rao SP, Wang Z, Zuberi RI, et al. Galectin-3 functions as an adhesion molecule to support eosinophil rolling and adhesion under conditions of flow[J]. J Immunol, 2007, 179(11):7800-7807.