关键词: 哮喘, 微RNAs, 糖皮质激素类, 诊断, 白细胞介素类, 干扰素γ, 免疫球蛋白E, 肿瘤坏死因子α, 激素敏 感性

Abstract: Objective To investigate the relationship between peripheral blood microRNA-1(miR-1) and acute attack of bronchial asthma, and its value in predicting the sensitivity of hormone therapy in patients with acute attack of bronchial asthma. Methods A total of 72 patients with acute exacerbation of bronchial asthma were used as the observation group, including 16 patients without inhaled glucocorticoid (ICS), 45 patients with steroid sensitive type (SS), and 11 patients with steroid resistant type (SR). In addition, 30 outpatients with health check-ups in the same period were included as the control group. Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the serum expression level of miR-1. The relationship between miR-1, interleukin (IL)-5, IL-6, IL-8, tumor necrosis factor α (TNF-α), interferon-γ (IFN-γ), immunoglobulin E (IgE), and fractional exhaled nitric oxide (FeNO) was analyzed by using Spearman rank correlation analysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of miR-1 in diagnosing the acute onset of bronchial asthma and the sensitivity of glucocorticoid therapy. Results The expression levels of miR-1 were significantly lower in the SS group and the SR group than those of the ICS-free group and the control group (P＜0.05). Spearman rank correlation analysis showed that miR-1 was positively correlated with IFN-γ, and negatively correlated with IL-5, IL-6, IL-8, TNF-α, IgE, and FeNO (all P＜0.01). ROC curve analysis showed that in the diagnosis of acute attack of bronchial asthma, the area under the curve (AUC) of miR-1 was higher among all test markers (AUC=0.794, 95%CI: 0.706- 0.882, P＜0.001). The results of joint diagnosis showed that the combination of miR-1 and IFN-γ had higher diagnostic efficiency (AUC=0.834, 95%CI: 0.757-0.912, P＜0.001). When predicting glucocorticoid sensitivity in asthmatic patients, the predictive value of miR-1 was fair (AUC=0.797, 95%CI: 0.668-0.926, P=0.002). The results of combined diagnosis showed that miR-1 combined with FeNO had higher diagnostic value (AUC=0.976, 95%CI: 0.928-1.000, P＜0.001). Conclusion The serum expression of microRNA-1 in patients with bronchial asthma is reduced, and it is expected to be a potential biomarker for the diagnosis of acute asthma. The level of miRNA-1 in peripheral blood of glucocorticoid resistant asthma patients is further reduced, suggesting that it can be one of the detection indicators used as a predictor of the sensitivity of glucocorticoid therapy in asthma patients.

Key words: asthma, microRNAs, glucocorticoids, diagnosis, interleukins, interferon-gamma, immunoglobulin E, tumor necrosis factor-alpha, hormone sensitivity