与病毒感染相关的1型免疫反应影响喘中的皮质类固醇反应
John V Fahy1, Nathan D Jackson2, Satria P Sajuthi2
1Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, California.
1型 (T1) 炎症在喘中很常见,通常与病毒感染有关,对皮质类固醇反应不佳. 然而,2型 (T2) 炎症对皮质类固醇有反应,影响喘严重程度和治疗结果.
科学领域:
- 免疫学 免疫学 免疫学
- 肺部病理学 肺部病理学
- 遗传学 遗传学 是一个
背景情况:
- 皮质类固醇反应型2 (T2) 炎症定义了T2高的喘内型.
- 1型 (T1) 炎症,可能与病毒感染有关,也可能影响喘中的皮质类固醇反应.
研究的目的:
- 确定T1高,T2高和T1/T2高喘内型的流行率和变异性.
- 调查病毒影响T1高喘是否影响皮质类固醇反应.
主要方法:
- 在严重喘研究计划-3 (SARP-3) 参与者中分析脏基因表达和病毒转基因组学.
- 基于T1和T2基因网络表达的患者分析,以评估内型特异性皮质类固醇反应和病毒关联.
主要成果:
- 22%的喘患者表现出高T1基因表达,35%的高T2,8.5%的两者.
- 高T2的喘显示出比T1更糟糕的结果;T1高/T2高的患者患病最严重.
- 皮质类固醇抑制了T2,但没有抑制T1基因表达,FEV1仅在T1-低/T2-高患者中得到改善.
- 在24%的样本中检测到病毒与T1高疾病的风险增加14倍相关.
结论:
- 呼吸道T1免疫反应在喘中普遍存在,并且在很大程度上对皮质类固醇有抗性.
- 高T1喘与亚临床病毒感染有关.
- 基于T1/T2炎症的喘内型鉴定对于了解皮质类固醇反应和疾病严重程度至关重要.
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