Objective To detect the correlation between fractional exhaled nitric oxide(FeNO),interleukin-17(IL-17),interleukin-27(IL-27)and lung function indexes,and to analyze the clinical diagnostic value for bronchial asthma in children. Methods A total of 84 children diagnosed with bronchial asthma in Nanyang Central Hospital were prospectively enrolled in this study from January 2019 to April 2020,meanwhile 56 healthy children were selected as control group.IL-17,IL-27 and FeNO levels of peripheral blood were tested,and pulmonary function-related indicators were recorded,including forced expiratory volume in one second(FEV1),forced expiratory volume in one second and vital capacity ratio(FEV1/FVC),peak expiratory flow rate(PEF),and ratio of residual volume to total lung volume(RV/TLC).Pearson correlation analysis was used to detect the correlation between IL-17,IL-27 and FeNO with lung function indexes.The ROC working curve was used to evaluate the diagnostic value of FeNO combined with IL-17 and IL-27 detection in childhood asthma. Results The differences of IL-17,IL-27,FeNO,FEV1,FEV1,FEV1/FVC,PEF and RV/TLC among the control group,stable phase and acute exacerbation phase groups were statistically significant(F=137.241,92.074,94.296,16.325,174.263,31.174,115.207,P<0.001).In children with asthma,IL-17 level was negatively correlated with FEV1,FEV1/FVC and PEF(r=-0.690,-0.576,-0.613),and positively correlated with RV/TLC(r=0.581).IL-27 level was negatively related to FEV1,FEV1/FVC and PEF(r=-0.786,-0.818,-0.549),and positively related to RV/TLC(r=0.513).FeNO level was negatively correlated with FEV1,FEV1/FVC and PEF(r=-0.667,-0.662,-0.637),and was positively correlated with RV/TLC(r=0.543).The sensitivity of IL-17,IL-27 and FeNO in the diagnosis of childhood asthma was 52.4%,68.5% and 70.6%,the specificity was 76.2%,63.2% and 65.3%,and the area under the curve was 0.684(95%CI:0.614—0.725),0.768(95%CI:0.710—0.805),0.792(95%CI:0.723—0.840),respectively.The sensitivity of the combined test for diagnosis of childhood asthma was 86.9%,the specificity was 81.4%,the area under the curve was 0.905(95%CI:0.802～0.941),and the difference was statistically significant compared with the single test(P<0.05). Conclusions The levels of IL-17,IL-27 and FeNO are correlated with lung function indexes.Joint detection can significantly improve the sensitivity and specificity of the diagnosis of bronchial asthma in children.
Key words
bronchial asthma /
interleukin-17 /
interleukin-27 /
fractional exhaled nitric oxide /
children
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References
[1] Thomas B,Chay OM,Allen JC Jr,et al.Concordance between bronchial hyperresponsiveness,fractional exhaled nitric oxide,and asthma control in children[J].Pediatr Pulmonol,2016,51(10):1004-1009.
[2] 全国儿科哮喘协作组,中国疾病预防控制中心环境与健康相关产品安全所.第三次中国城市儿童哮喘流行病学调查[J].中华儿科杂志,2013,51(10):729-735.
[3] Ducharme FM,Dell SD,Radhakrishnan D,et al.Diagnosis and management of asthma in preschoolers:A Canadian Thoracic Society and Canadian Paediatric Society position paper [J].Can Respir J,2015,22(3):135-143.
[4] Wang Z,Sun J,Liu Y,et al.Impact of atopy on the severity and extrapulmonary manifestations of childhood Mycoplasma pneumoniae pneumonia[J].J Clin Lab Anal,2019,33(5):e22887.
[5] Nguyen TH,Maltby S,Tay HL,et al.Identification of IFN-γ and IL-27 as critical regulators of respiratory syncytial virus-induced exacerbation of allergic airways disease in a mouse model[J].J Immunol,2018,200(1):237-247.
[6] Zhu H,Zhang R,Hao C,et al.Fractional exhaled nitric oxide(FeNO) combined with pulmonary function parameters shows increased sensitivity and specificity for the diagnosis of cough variant asthma in children[J].Med Sci Monit,2019,25:3832-3838.
[7] 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(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[8] Nanzer AM,Chambers ES,Ryanna K,et al.Enhanced production of IL-17A in patients with severe asthma is inhibited by 1alpha,25-dihydroxyvitamin D3 in a glucocorticoid-independent fashion[J].J Allergy Clin Immunol,2013,132(2),132:297-304.
[9] Alcorn JF,Crowe CR,Kolls JK.Th17 cells in asthma and COPD [J].Annu Rev Physiol,2010,72:495-516.
[10] 赵生涛.IL-17 在中性粒细胞性哮喘中的作用及其调控气道炎症表型的机制研究 [D].重庆:第三军医大学,2017:60-62.
[11] Dragon S,Rahman MS,Yang J,et al.IL-17 enhances IL-1 beta-mediated CXCL-8 release from human airway smooth muscle cells [J].Am J Physiol Lung Cell Mol Physiol,2007,292(4):L1023-L1029.
[12] Pflanz S,Timans JC,Cheung J,et al.IL-27,a heterodimeric cytokine composed of EBI3 and p28 protein,induces proliferation of naive CD4+ T cells[J].Immunity,2002,16(6):779-790.
[13] Kalliolias GD,Ivashkiv LB.IL-27 activates human monocytes via STAT1 and suppresses IL-10 production but the inflammatory functions of IL-27 are abrogated by TLRs and p38 [ J].J Immunol,2008,180(9):6325-6333.
[14] Dong S,Zhang X,He Y,et al.Synergy of IL-27 and TNF-alpha in regulating CXCL10 expression in lung fibroblasts[J].Am J Respir Cell Mol Biol,2013,48(4):518-530.
[15] Giudice MMD,Marseglia GL,Leonardi S,et al.Fractional exhaled nitric oxide measurements in riniti and asthma in children[J].Int J Immunopathol Pharmacol,2016,24(Suppl 4):29-32.
[16] Mansour AI,Abd-Almonaem ER,Behairy OG,et al.Predictive value of IL-35 and IL-17 in diagnosis of childhood asthma[J].Scand J Clin Lab Invest,2017,77(5):373-378.
[17] Abo-ElMagd NM,Abdel-Salam SA,Aly YA,et al.The role of serum interleukin-27 as a diagnostic biomarker for diagnosis of neonatal sepsis[J].Egypt J Immunol,2018,25(2):87-95.
[18] Zhang M,Xiong D,Li H,et al.Diagnostic value of T-Spot TB combined with INF-gamma and IL-27 in tuber-culous pleurisy[J].Exp Ther Med,2018,15(2):1871-1874.
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