TY -的T1 -升高血清IgE,口服皮质类固醇依赖性和IL-17/22表达高度中性粒细胞哮喘JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.00068 -2019欧元六世- 54 - 5 SP - 1900068 AU -布伦,Michela盟——Carriero Vitina AU -名导,弗朗西斯卡盟——Folino安娜盟——Mannelli亚历山德罗盟迪斯蒂法诺,Antonino AU - Gnemmi,伊莎贝拉盟——Torchio罗伯托盟——Ricciardolo,法比奥L.M. Y1 - 2019/11/01 UR - //www.qdcxjkg.com/content/54/5/1900068.abstract N2 -信息的临床特征与支气管哮喘的嗜中性,防止其识别和适当的治疗。我们旨在评估中性粒细胞性哮喘的临床、功能和生物学特征，并确定支气管中性粒细胞性哮喘的可能预测因子。根据70例轻、重度哮喘患者支气管固有层嗜酸性粒细胞/嗜中性粒细胞计数，对其炎症表型进行横断面研究。患者分为中性粒细胞或非中性粒细胞。中性粒细胞哮喘患者(中性粒细胞计数截止日期:47.17中性粒细胞·mm−2;范围:47.17 - -198.11中性粒细胞·mm−2;中位数:94.34个中性粒细胞·mm−2)进一步分为高(≥94.34个中性粒细胞·mm−2)和中位数(47.17个中性粒细胞·mm−2)。研究还评估了吸烟≥10包年的影响。嗜中性哮喘患者(n=38;36例嗜酸性粒细胞/嗜中性粒细胞混合性哮喘患者与非嗜中性粒细胞哮喘患者相比，病情严重程度、功能性剩余容量、吸入皮质类固醇(ICS)剂量和加重情况更严重，1 s (FEV1)可逆性强迫肺活量(FVC) %和强迫呼气量更低(n=32; 28 eosinophilic and four paucigranulocytic). Neutrophilic asthma patients had similar eosinophil counts, increased bronchial CD8+, interleukin (IL)-17-F+ and IL-22+ cells, and decreased mast cells compared with non-neutrophilic asthma patients. FEV1 and FVC reversibility were independent predictors of bronchial neutrophilia in our cohort. High neutrophilic patients (n=21) had increased serum IgE levels, sensitivity to perennial allergens, exacerbation rate, oral corticosteroid dependence, and CD4+ and IL-17F+ cells in their bronchial mucosa. Excluding smokers revealed increased IL-17A+ and IL-22+ cells in highly neutrophilic patients.We provide new evidence linking the presence of high bronchial neutrophilia in asthma to an adaptive immune response associated with allergy (IgE) and IL-17/22 cytokine expression. High bronchial neutrophilia may discriminate a new endotype of asthma. Further research is warranted on the relationship between bronchoreversibility and bronchial neutrophilia.Asthma with high bronchial neutrophilia is associated with increased serum IgE, perennial allergy and IL-17 expression combined with CD4+ cells. This new endotype is clinically associated with exacerbation rate in the previous year and OCS dependence. http://bit.ly/2ZqboJ2 ER -