| Bronchial asthma in children is a chronic inflammatory disease of the airway involving a variety of inflammatory cells(eosinophils,mast cells,T lymphocytes,neutrophils,etc.),airway smooth muscle cells and airway epithelial cells.In recent years,the incidence of bronchial asthma is still on the rise,which has caused a serious burden on the family economy and a far-reaching impact on social developent.Therefore,the early detection,diagnosis and treatment of childhood bronchial asthma are of great importance;But in recent years,a large number of studies have found that preschool children with bronchial asthma its atypical clinical characteristics,the main detection methods is not sensitive and early airway damage influence preschool bronchial asthma early diagnosis and prognosis of the most important factors,so the preschool period the pathogenesis of bronchial asthma has received the attention of the researchers.FeNO,as an indicator to evaluate the severity of airway eosinophilic inflammation in asthma patients,has been widely used in clinical work in recent years due to its advantages of standardization,rapidity,noninvasiveness,simplicity and easy replication.In addition,through a large number of studies in recent years,we found that Th1/Th2 is an important mechanism in the pathogenesis of asthma,in which IL-5,a cytokine secreted by Th2 cells,is mainly responsible for the maturation,activation,proliferation and recruitment of eosinophils to the airway,and plays an important role in eosinophilic airway inflammation.Recently,IL-37,a newly discovered cytokine secreted by Th1 cells,plays an important role in inhibiting airway inflammation in bronchial asthma.However,the correlation between FeNO,IL-5,IL-37 and blood EOS in the pathogenesis of bronchial asthma in the early school age has not been reported in China.Therefore,this paper will provide scientific basis for the early diagnosis and targeted treatment of bronchial asthma in the early school age.Objective1.To understand the differences in FeNO,serum IL-5,serum IL-37,blood EOS and other indicators among the children with and without bronchial asthma at the early school age,so as to provide clinical basis for the early diagnosis of bronchial asthma at the early school age;2.To explore the correlation between FeNO,serum IL-5,serum IL-37,blood EOS and other indicators in the pathogenesis of bronchial asthma in the early school age,so as to provide reference for future clinical targeted therapy.Materials and methods1.Collection We select the 60 school-age children with acute bronchial asthma initially diagnosed by clinical and examination in the outpatient department and inpatient department of pediatric respiratory medicine in the third affiliated hospital of zhengzhou university from November 2017 to August 2018 as the observation group.Thirty children of the same age who were hospitalized in pediatric surgery department of our hospital due to the need of elective surgery in the same period were selected as healthy control group.Serum samples were collected from each group for the detection of IL-5,IL-37 and EOS,etc.FeNO test was required for asthma patients,in which age+8 was the tangent point,above which was asthma group I,and below which was asthma group II.There were 36 cases in asthma I group and 24 cases in asthma II group.Meanwhile,case data of all subjects were reviewed and analyzed.All data were analyzed using SPSS21.0 statistical software,and all measurement data were expressed.The t-test of two independent samples was used for the comparison between groups,and Pearson test was used for the correlation analysis of the two variables.The test level was=0.05,and P<0.05 was statistically significant.2.This study met the standards of the hospital ethics committee,and was approved by the ethics committee.The informed consent of the guardian of the sick child was obtained,and a written informed consent was signed.Results1.Comparison of serum IL-5 levels among the three groups:the serum IL-5levels in the asthma group I,asthma group II and control groups were(0.21±0.02)pg/ml,(0.19±0.01)pg/ml and(0.170±.01)pg/ml,respectively.The level of serum IL-5 in the asthma group I was higher than that in the asthma group II and the control group,and the differences of serum IL-5 levels in the three groups were statistical-ly significant(F=3.65,P=0.028)(see table 1 and figure 1).2.Comparison of serum IL-37 levels among the three groups:asthma group I,asthma group II and control group,the serum IL-37 levels were(0.09±0.01)pg/ml,(0.13±0.03)pg/ml,and(0.150±.02)pg/ml,respectively.The level of serum IL-37in the asthma group I was lower than that in the asthma group II and the control group,and the differences of serum IL-37 levels in the three groups were statistically signifi-cant(F=18.7,P=0.019)(see table 1 and figure 2).3.Blood EOS counts in the asthma group I,asthma group II and control groups were(0.56±0.04)×10~9mmol/l,(0.14±0.02)×10~9mmol/l,(0.12±0.01)×10~9mmol/l,respectively.The blood EOS count of the asthma group I was higher than that of the asthma group II and the control group,and the differences among the three groups were statistically significant(F=7.82,P=0.016)(see table 1 and figure 3).4.Correlation analysis Pearson linear analysis showed that serum IL-5 level was negatively correlated with serum IL-37 level(R=-0.824,P<0.05)(see figure 4);Serum IL-5 level was positively correlated with blood EOS count(R=0.758,P<0.05)(see figure 5);FeNO level was positively correlated with serum IL-5 level(R=0.656,P<0.05)(see figure 6).FeNO level was negatively correlated with serum IL-37 level(R=-0.543,P<0.05)(see figure 7).Conclusions1.Imbalance of serum il-5 and il-37 secretion may promote abnormal aggregation of eosinophils in the blood and airway,which plays an important role in the pathogenesis of asthma.2.The increased FeNO level is closely related to the abnormal secretion of IL-5and IL-37,which may be used as a biomarker to evaluate the degree of abnormal secretion of cytokines. |
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