CAJ | 학술논문

目的探讨支气管哮喘及慢性阻塞性肺疾病(COPD)患者诱导痰中高迁移率组蛋白B1( HMGB1)的表达及其与气道炎症的关系.方法按标准纳入慢性持续期哮喘患者57例,稳定期的COPD患者30例,对照组(健康体检者)20例;完成哮喘控制问卷后,分别进行肺功能检测和诱导痰检查,记录第1秒用力呼气容积( FEV1)占预计值的百分比(FEV1％预计值),行诱导痰中性粒细胞分类计数,酶联免疫吸附法检测诱导痰HMGB1水平.结果哮喘组、COPD组诱导痰HMGB1水平分别为(291±55)、(511±39) ng/L,显著高于对照组的(61±5)ng/L(均P＜0.01);在107例研究对象中,HMGB1的表达与FEV1％预计值呈反比;COPD组诱导痰HMGB1水平显著高于哮喘组(P＜0.01).嗜酸粒细胞哮喘组与非嗜酸粒细胞哮喘组HMGB1水平分别为(290 +55)、(292±54) ng/L,差异无统计学意义(P＞0.05).Ⅱ、Ⅲ级COPD患者HMGB1水平分别为(526±29)、(541±29 )ng/L,显著高于Ⅰ级的(471±18)ng/L(均P＜0.01).轻、中、重度持续期哮喘患者诱导痰中性粒细胞比例分别为(27±2)％、(36±4)％、(49±4)％,HMGB1水平分别为(227±16)、(312±14)、(347±11) ng/L,差异均有统计学意义(均P＜0.01).哮喘及COPD患者诱导痰中HMGB1与中性粒细胞比例均呈正相关(r值分别为0.880和0.132,均P＜0.01).年龄、性别、嗜酸粒细胞比例均不是影响HMGB1表达的显著性因素,诱导痰中性粒细胞比例和FEV1％预计值与HMGB1表达水平关系显著(t=-3.059,P =0.005).结论 HMGB1在支气管哮喘及COPD患者诱导痰中呈高表达,对气道炎症有增强作用.
목적 탐토지기관효천급만성조새성폐질병(COPD)환자유도담중고천이솔조단백B1( HMGB1)적표체급기여기도염증적관계.방법 안표준납입만성지속기효천환자57례,은정기적COPD환자30례,대조조(건강체검자)20례;완성효천공제문권후,분별진행폐공능검측화유도담검사,기록제1초용력호기용적( FEV1)점예계치적백분비(FEV1％예계치),행유도담중성립세포분류계수,매련면역흡부법검측유도담HMGB1수평.결과 효천조、COPD조유도담HMGB1수평분별위(291±55)、(511±39) ng/L,현저고우대조조적(61±5)ng/L(균P＜0.01);재107례연구대상중,HMGB1적표체여FEV1％예계치정반비;COPD조유도담HMGB1수평현저고우효천조(P＜0.01).기산립세포효천조여비기산립세포효천조HMGB1수평분별위(290 +55)、(292±54) ng/L,차이무통계학의의(P＞0.05).Ⅱ、Ⅲ급COPD환자HMGB1수평분별위(526±29)、(541±29 )ng/L,현저고우Ⅰ급적(471±18)ng/L(균P＜0.01).경、중、중도지속기효천환자유도담중성립세포비례분별위(27±2)％、(36±4)％、(49±4)％,HMGB1수평분별위(227±16)、(312±14)、(347±11) ng/L,차이균유통계학의의(균P＜0.01).효천급COPD환자유도담중HMGB1여중성립세포비례균정정상관(r치분별위0.880화0.132,균P＜0.01).년령、성별、기산립세포비례균불시영향HMGB1표체적현저성인소,유도담중성립세포비례화FEV1％예계치여HMGB1표체수평관계현저(t=-3.059,P =0.005).결론 HMGB1재지기관효천급COPD환자유도담중정고표체,대기도염증유증강작용.
Objective To explore the relationship between the sputum levels of high mobility group protein B1 ( HMGB1 ) and airway inflammation in bronchial asthma and chronic obstructive pulmonary disease (COPD) patients.Methods A total of 57 patients with persistent asthma [ per Global Initiative for Asthma (GINA) guidelines ],30 patients with stable COPD [ stratified by Global Initiative for COPD (GOLD) status] and 20 control subjects were recruited.After completing an asthma control questionnaire,spirometry was performed before sputum induction.The ratio of forced expiratory volume in the first second (FEV1)/predictive value (FEV1 ％ Pre) and neutrophil differential count in induced sputum were recorded.The concentrations of HMGB1 in the supernatant of sputum were measured by ELISA (enzyme-linked immunosorbent assay).Results The sputum concentrations of HMGB1 in the asthmatics and COPD patients were significantly higher than those of the control subjects [ (291 ±55) and (511 ±39) vs (61 ±5) ng/L,all P ＜0.01 ].And they were significantly negatively correlated with FEV1％Pre in all subjects.The levels of HMGB1 in induced sputum of COPD patients were significantly higher than those of asthmatics and healthy controls ( P ＜ 0.01 ).No significant difference existed in the levels of HMGB1 between patients with eosinophilic and noneosinophilic asthma [ (290 ± 55 ) vs (292 ± 54) ng/L,P ＞ 0.05 ].The HMGB1 levels with COPD stage Ⅱand stage Ⅲwere significantly higher than those with stage Ⅰ [ (526 ±29) and (541 ±29) vs (471 ± 18) ng/L].The differences of sputum neutrophil percentage were statistically significant in mild,moderate and severe asthma [ (27 ± 2) ％,( 36 ± 4) ％,(49 ± 4) ％ ].And the sputum levels of HMGB1 were significantly higher in the patients with moderate and severe asthma [ (312 + 14) vs (347 ±11 ) ng/L].And the levels of HMGB1 in asthmatic and COPD patients were positively correlated with neutrophil percentage.According to the multivariate analysis,neutrophil percentage and FEV1 ％ Pre were independent predictors of sputum HMGB1,but not smoking,age,gender and eosinophilic percentage.Conclusion HMGB1 may contribute to airway inflammation through its higher expression in bronchial asthma and COPD patients.