常见的炎症标志物预测了患有囊性纤维化儿童的ABPA发展风险
Harriet E D Crabtree1, Chris J Malajczuk2, Ho Yin Ho3
1Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Perth, Australia.
概括
在患有囊性纤维化 (CF) 的儿童中,可以使用常规生物标志物早期检测过敏性支气管肺性阿斯伯吉洛症 (ABPA). 总体IgE,埃索诺菲尔和阿斯伯吉勒斯特异性IgE的持续正常水平表明ABPA的风险较低.
科学领域:
- 儿科肺病学 儿科肺病学
- 免疫学 免疫学 免疫学
- 生物标志物发现发现
背景情况:
- 过敏性支气管肺性阿斯伯吉洛症 (ABPA) 在患有囊性纤维化 (CF) 的儿童中会导致渐进性肺损伤.
- 由于非特异性症状和潜伏性发作,早期ABPA诊断具有挑战性.
- 常规收集的生物标志物可能有助于预测儿科CF患者的ABPA风险.
研究的目的:
- 评估总IgE,乙素 (Eo) 和Aspergillus特异性IgE (Asp-sp IgE) 对CF儿童ABPA发育的预测效益.
- 确定与可忽略的ABPA风险相关的生物标志物值.
主要方法:
- 从2000年到2020年,对患有CF的儿童 (0-18岁) 的回顾性分析.
- 在ABPA诊断之前,对总IgE,Eo和Asp-spIgE水平的纵向监测.
- 生物标志物水平与年龄和性别匹配的对照进行比较.
主要成果:
- 在346名CF儿童中,有19名 (5.4%) 被诊断为ABPA.
- 在临床ABPA诊断前长达五年,观察到总IgE,Eo和Asp-spIgE的升高.
- 总IgE<500 IU/mL,Asp-spIgE<0.35 IU/mL,Eo<0.5 × 10^9细胞/L的儿童在五年内患有ABPA的风险为<1.0%.
结论:
- 在ABPA之前的生物标志物升高是逐渐和持久的,而不是突然的.
- 至少两种总IgE,Eo和Asp-spIgE的低水平表明至少五年内ABPA风险可以忽略不计.
- 持续正常或低生物标志物水平的儿童可能需要更少的ABPA查.
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