Study Of POSTN And Other Inflammation-related Mediators In Peripheral Blood During Acute Episodes Of Wheezing In Infants And Young Children

Objective By analyzing the changes in peripheral blood levels of inflammation-related mediators during acute episodes,the article aims to further explore the possible pathogenesis of acute episodes of wheezing in infants and children,and identify serum markers for early prediction of asthma onset,thus and providing broader prospects for the prevention and treatment of wheezing in infants and children.Methods Sixty-six infants and toddlers admitted to the First Affiliated Hospital of Nanchang University from October 2021 to October 2022 with acute episodes of wheezing were selected as the wheezing group(47 males,19 females,mean age22.3±9.6 months)and 32 infants and toddlers without acute episodes of wheezing with lower respiratory tract infections were selected as the non-asthmatic group(21males,11 females,mean age 21.8±10.4 months).Another Thirty-two healthy infants examined in our outpatient clinic were selected as the healthy control group(22 males and 10 females,mean age 21.9±9.3 months).For children in the wheezing group,they were classified into 35 asthma cases and 31 non-asthma cases according to the total score of ≥4 on the model of asthma diagnostic criteria for children under 6years of age;36 cases were classified into the early-onset group(≤3 days)and 30 cases into the late-onset group(>3 days)according to whether the duration of coughing and wheezing was more than 3 days at the time of admission;20 cases were classified into the severe group and 46 cases were classified into the mild group according to the severity of the current wheezing episode;29 cases with one or more positive pathogenic test results were included in the pathogenic positive group,37 cases with all negative results were included in the pathogenic negative group;43cases in the febrile group and 23 cases in the non-febrile group were classified according to whether the axillary temperature exceeded 37℃ during the course of the illness.The levels of peripheral blood osteopontin(POSTN),interleukin(IL)-4,IL-13,tumour necrosis factor(TNF)-α and interferon(INF)-γ were measured and compared among the groups.Eosinophil(EOS)counts and 48 serum total immunoglobulin E(TIgE)measurements were also collected during this hospitalization for correlation analysis.Results1.Comparison of the levels of various inflammatory factors in peripheral blood of children among the wheezing,non-asthmatic and healthy control groups.The level of POSTN,IL-4 and IL-13 were higher in the wheezing group than in the non-asthmatic and healthy control group,with statistically significant differences(P<0.01),while the differences in the non-asthmatic and healthy control groups were not statistically significant(P>0.05).The level of TNF-α in the wheezing group and in the non-asthmatic group were both higher than that in the health control group,the difference was statistically significant(P<0.01)in both cases.The level of INF-γ in the wheezing group was lower than that in the non-asthmatic group and the healthy control group,and the difference was statistically significant(P<0.01);the difference between the non-asthmatic group and the healthy control group was not statistically significant(P>0.05).2.Comparison of the levels of various inflammatory factors in peripheral blood during episodes among different groups.The differences in the levels of peripheral blood POSTN,IL-4,IL-13 and TNF-α were not statistically significant between the asthma and non-asthma groups,the early and late asthma groups,the positive and negative pathogenic groups,and between the febrile and non-febrile groups(P>0.05);however,INF-γ levels in the early group were lower than those in the late group.POSTN and IL-13 levels were higher in the severe group than in the mild group,and the difference was statistically significant(P<0.05);INF-γ levels were lower in the severe group than in the mild group,and the difference was statistically significant(P<0.05).3.Correlation analysis.In the wheezing group,the peripheral blood POSTN levels showed a significant positive correlation with IL-4 and IL-13 levels(P<0.01);IL-4levels showed a significant positive correlation with IL-13 levels(P<0.01);POSTN,IL-4 and IL-13 levels showed a significant negative correlation with INF-γ levels(P<0.01).In contrast,TNF-α levels did not correlate with POSTN,IL-4,IL-13 and INF-γ levels(P>0.05).Also In the wheezing group,peripheral blood POSTN,IL-4and IL-13 levels were significantly and positively correlated with EOS count and TIgE level in the wheezing group(P<0.01);INF-γ levels were significantly and negatively correlated with EOS count and TIgE level(P<0.01);TNF-α levels were not correlated with EOS count and TIgE level(P > 0.05).Conclusion1.There are multiple cytokine disorders in acute episodes of wheezing in infants and young children,manifested by high expression of POSTN,TNF-α and Th2,suggesting that POSTN,IL-4,IL-13,TNF-α and INF-γ may be involved in the pathogenesis of wheezing in infants and young children through complex mechanisms and interactions with EOS count and TIgE.2.The airway inflammation in acute episodes of wheezing in infants and children is related to the severity of condition,but not to the diagnosis of infantile asthma,positive pathogenic tests,or fever.INF-γ levels may be related to the duration of the same wheezing episode.3.TNF-α may also play a role in the pathogenesis of lower respiratory tract infections in children.