Association Between Epithelial Cytokines and Clinical Phenotypes of Elderly Asthma

PURPOSE: Asthma in the elderly has different clinical features including more severe phenotypes with higher comorbidities. Epithelial cells are known to initiate innate/adaptive immune responses in asthmatic airways. We investigated clinical features and epithelial derived cytokine levels in elderly asthmatics compared to non-elderly asthmatics in a cross-sectional cohort of adult asthmatics in order to further understand its pathogenic mechanisms. METHODS: A total of 1,452 adult asthmatics were enrolled from a single tertiary hospital and were classified into 2 groups: 234 elderly (≥ 60 years at initial diagnosis) and 1,218 non-elderly (< 60 years at initial diagnosis) asthmatics. Asthma-related clinical parameters were compared between the 2 groups. Serum levels of epithelial cell-derived cytokines including interleukin (IL)-31, IL-33, IL-8, eotaxin-2, transforming growth factor beta 1 (TGF-β1) and periostin were measured by enzyme-linked immunosorbent assay. RESULTS: Significantly higher prevalence rates of late-onset asthma (onset age ≥ 40 years) and severe asthma, as well as the lower rate of atopy, blood/sputum eosinophil counts, total immunoglobulin E and eosinophil cationic protein levels were noted in elderly asthmatics compared to non-elderly asthmatics (P < 0.05, respectively). The forced expiratory volume in 1 second (FEV1, % predicted) level tended to be lower in elderly asthmatics (P = 0.07). In addition, serum IL-33 and IL-31 levels were significantly lower in elderly asthmatics, while no differences were found in the serum level of IL-8, eotaxin-2, TGF-β1 or periostin. Among elderly asthmatics, subjects with severe asthma had lower FEV1 (% predicted) value, but showed significantly higher serum levels of eotaxin-2 and TGF-β1, than those with non-severe asthma (P < 0.05 for each). CONCLUSIONS: These findings suggest that age-related changes of epithelial cell-derived cytokines may affect clinical phenotypes and severity of elderly asthma: decreased levels of IL-33 and IL-31 may contribute to less Th2 phenotype, while increased levels of eotaxin-2 and TGF-β1 may contribute to severity.

Correlations of plasma eotaxin-2, sTNFR Ⅱ and other cytokines levels with the status of metabolic syndrome in type 2 diabetic nephropathy patients treated with maintenance hemodialysis / 临床检验杂志

Objective To investigate the correlations of plasma eotaxin-2,soluble tumor necrosis factor receptor(sTNFR) Ⅱ and other cytokines levels with the status of metabolic syndrome(MS) in type 2 diabetic nephropathy (DN) patients treated with maintenance hemodialysis(MHD).Methods Thirty type 2 DN patients with stable pathogenetic conditions and MHD treatment for more than 3 months,thirty newly diagnosed and untreated type 2 diabetes(T2D) patients and thirty healthy volunteers were enrolled in the study.The MS related markers,including blood pressure,waist circumference,body mass index,triglyceride(TG),high density lipoprotein cholesterol(HDL-C),fasting blood glucose (FBG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C) and C reactive protein(CRP),were determined.The expression levels of 40 cytokines were detected with the AAH-INF-G3 antibody microarray,and their correlations with MS related markers were analyzed by the Pearson method.Results The incidence rates of MS in DN patients with MHD and T2D patients were 88.89％ and 33.33％,respectively.Compared with T2D patients and healthy controls,the DN patients had more MS related markers,higher waist circumference and lower body mass index,and their plasma eotaxin-2,I-309 and sTNFR Ⅰ / Ⅱ levels increased significantly.Pearson correlation analysis showed that plasma eotaxin-2 and I-309 levels were positively related to MS risk factors such as TG,FBG and diastolic blood pressure(DBP) levels.Plasma sTNFR Ⅱ and I-309 levels were significantly positively correlated with plasma CRP levels.Conclusion A micro inflammatory state exists in type 2 DN patients with MHD.Abnormal glycolipid metabolism may influence on the immunologic and physiological state of human body,and then form the micro inflammatory state.Eotaxin-2 and I-309 may participate in this chronic and persistent process and further induce renal damage by upregulating sTNFR Ⅰ / Ⅱ levels,which may result in the formation of MS state in type 2 DN patients with MHD.