■奥马珠单抗是一种有效的抗免疫球蛋白E(IgE)治疗过敏性哮喘。嗜酸性粒细胞在过敏性气道炎症的发病机制中起着至关重要的作用。本研究旨在探讨奥马珠单抗有效治疗对循环嗜酸性粒细胞的影响。
纳入研究的过敏性哮喘患者用奥马珠单抗治疗至少16周,根据每位患者和专科医生评估的治疗有效性全球评估(GETE),表现出良好或优异的反应。嗜酸性粒细胞功能评估,分离外周血嗜酸性粒细胞;通过流式细胞术检测人白细胞抗原(HLA)-DR和共刺激分子分化簇(CD)80,CD86和CD40的表达,并在奥马珠单抗治疗前和治疗16周后测定血清中eotaxin-1的浓度.
■共32名对奥马珠单抗治疗反应积极的过敏性哮喘患者纳入研究。Omalizumab应答者显示治疗后外周嗜酸性粒细胞上共刺激分子CD40,CD80和CD86的表达以及血清eotaxin-1浓度的显着下降。在奥马珠单抗治疗后,CD80+嗜酸性粒细胞的变化与第一秒用力呼气量(FEV1)/用力肺活量(FVC)%预测和最大呼气流量(MEF)25%的变化之间观察到负相关(r=-0.61,P=0.048)。奥马珠单抗改善FEV1/FVC%预测(3.88,P=0.033),呼出气一氧化氮(FeNO,-22.24,P=0.028),哮喘控制测试(ACT,4.22,P<0.001),迷你哮喘生活质量问卷(mini-AQLQ,-14.44,P=0.019),莱斯特咳嗽问卷(LCQ,3.03,P=0.009)和视觉模拟评分(VAS)对重度过敏性哮喘患者的过敏症状(-13.00,P=0.001)具有统计学意义;减少的迷你鼻结膜炎生活质量问卷(mini-RQLQ,-8.50,P=0.047),和焦虑自评量表(SAS,-5.08,P=0.040)在伴有过敏性鼻炎(AR)或焦虑的过敏性哮喘患者中,分别。
■我们的研究结果表明,奥马珠单抗在减少严重过敏性哮喘患者嗜酸性粒细胞和血清eotaxin-1水平的共刺激分子表达方面具有独特的作用,同时改善了过敏性疾病的多个临床参数。
UNASSIGNED: Omalizumab is an effective anti-immunoglobulin E (IgE) treatment for allergic asthma. Eosinophil plays a critical role in the pathogenesis of allergic airway inflammation. This study aimed to explore the influence of effective omalizumab treatment on circulating eosinophils.
UNASSIGNED: Allergic asthmatics enrolled in the study were treated with omalizumab for at least 16 weeks and exhibited a good or excellent response according to the global evaluation of treatment effectiveness (GETE) assessed by each patient and specialist physician. For eosinophil functional evaluation, peripheral blood eosinophils were separated; and examined the expression of human leukocyte antigen (HLA)-DR and co-stimulatory molecules cluster of differentiation (CD) 80, CD86 and CD40 by Flow Cytometry and serum were to measure the concentration of eotaxin-1 before and after 16 weeks of omalizumab treatment.
UNASSIGNED: Totally 32 allergic asthma patients who responded positively to omalizumab treatment were included. Omalizumab responders showed a significant decline in the expression of co-stimulatory molecules CD40, CD80, and CD86 on peripheral eosinophils and in serum eotaxin-1 concentration after treatment. Negative correlations (r=-0.61, P=0.048) were observed between the change in CD80+ eosinophils and the change in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC)% predicted and maximal expiratory flow (MEF) 25% after omalizumab treatment. Omalizumab improved FEV1/FVC% predicted (3.88, P=0.033), fractional exhaled nitric oxide (FeNO, -22.24, P=0.028), asthma control test (ACT, 4.22, P<0.001), mini asthma quality of life questionnaire (mini-AQLQ, -14.44, P=0.019), Leicester cough questionnaire (LCQ, 3.03, P=0.009) and visual analogue scale (VAS) for allergic symptoms (-13.00, P=0.001) in patients with severe allergic asthma statistically; reduced mini rhino-conjunctivitis quality of life questionnaire (mini-RQLQ, -8.50, P=0.047), and self-rating anxiety scale (SAS, -5.08, P=0.040) in allergic asthmatics with concomitant allergic rhinitis (AR) or anxiety, respectively.
UNASSIGNED: Our findings show a unique role of omalizumab in reducing co-stimulatory molecules expression on eosinophil and serum eotaxin-1 levels in severe allergic asthmatics accompanied by improvement of multiple clinical parameters of allergic diseases.