천식 소아에서 혈청 vascular endothelial growth factor, transforming growth factor-beta1과 YKL-40 증가의 임상적 의의
Clinical significance of increased vascular endothelial growth factor, transforming growth factor-beta1, and YKL-40 in the serum of children with asthma
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Purpose: Vascular endothelial growth factor (VEGF), transforming growth factor beta1 (TGF-β1), and platelet derived growth factor (PDGF) are known to be involved in the pathogenesis of inflammation and remodeling in asthmatic airways. YKL-40, a chitinase-like protein, and clusterin have been reported to be biomarkers for severe asthma. We examined the serum levels of growth factors, YKL-40, and clusterin in children with acute asthma or stable asthma, and investigated their correlation with clinical findings and lung function parameters. Methods: Forty-one children (≥6 years of age) with asthma were enrolled, and 2 groups were defined: 23 patients admitted with acute asthma (acute asthma group) and 18 patients with stable asthma (stable asthma group). The serum levels of VEGF, TGF-β1, PDGF-BB, YKL-40, and clusterin were measured using enzyme-linked immunosorbent assay and assessed in relation to clinical manifestations and spirometric parameters. Fifteen age-matched controls were also studied. Results: The serum levels of VEGF, TGF-β1, and YKL-40 were significantly elevated in children with acute asthma compared to controls. The serum levels of VEGF and YKL-40 were higher in the stable asthma group than in controls. The serum levels of VEGF, TGF-β1, and YKL-40 were not different between the acute asthma and stable asthma groups. The serum VEGF levels in the acute asthma group correlated significantly with asthma severity. The serum TGF-β1 levels in stable asthma group showed a significant inverse correlation with (FEV1) forced expiratory volume in one second and FEF25%–75% (forced expiratory flow between 25 and 75 percent of expired vital capacity). Serum YKL-40 had no significant relationship with clinical manifestations and spirometric parameters. Conclusion: Our study suggests that increased serum levels of VEGF and YKL-40 might affect asthmatic airways not only during acute exacerbation but also in stable state and that serum TGF-β1 might be a biomarker for airway obstruction in children with asthma.
Abstract
Purpose: Vascular endothelial growth factor (VEGF), transforming growth factor beta1 (TGF-β1), and platelet derived growth factor (PDGF) are known to be involved in the pathogenesis of inflammation and remodeling in asthmatic airways. YKL-40, a chitinase-like protein, and clusterin have been reported to be biomarkers for severe asthma. We examined the serum levels of growth factors, YKL-40, and clusterin in children with acute asthma or stable asthma, and investigated their correlation with clinical findings and lung function parameters. Methods: Forty-one children (≥6 years of age) with asthma were enrolled, and 2 groups were defined: 23 patients admitted with acute asthma (acute asthma group) and 18 patients with stable asthma (stable asthma group). The serum levels of VEGF, TGF-β1, PDGF-BB, YKL-40, and clusterin were measured using enzyme-linked immunosorbent assay and assessed in relation to clinical manifestations and spirometric parameters. Fifteen age-matched controls were also studied. Results: The serum levels of VEGF, TGF-β1, and YKL-40 were significantly elevated in children with acute asthma compared to controls. The serum levels of VEGF and YKL-40 were higher in the stable asthma group than in controls. The serum levels of VEGF, TGF-β1, and YKL-40 were not different between the acute asthma and stable asthma groups. The serum VEGF levels in the acute asthma group correlated significantly with asthma severity. The serum TGF-β1 levels in stable asthma group showed a significant inverse correlation with (FEV1) forced expiratory volume in one second and FEF25%–75% (forced expiratory flow between 25 and 75 percent of expired vital capacity). Serum YKL-40 had no significant relationship with clinical manifestations and spirometric parameters. Conclusion: Our study suggests that increased serum levels of VEGF and YKL-40 might affect asthmatic airways not only during acute exacerbation but also in stable state and that serum TGF-β1 might be a biomarker for airway obstruction in children with asthma.
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