Expression of TGF-β1 and Smad3 in children with asthma and vitamin D adjuvant treatment of children with asthma
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摘要: 目的 探讨转化生长因子β1(TGF-β1)、Smad3在哮喘患儿中的表达及维生素D辅助治疗儿童哮喘的疗效。方法 选取2022年4月—2023年6月于徐州医科大学附属医院就诊的120例轻度持续期哮喘患儿作为哮喘组,另取同期该院体检的80例健康儿童作为对照组。比较2组儿童血清TGF-β1、Smad3的表达水平。按照随机数字表法将哮喘组分为A组和B组,每组60例。比较A、B组患儿在治疗前、治疗1个月及3个月血清25(OH)D、TGF-β1、Smad3、呼出气一氧化氮(FeNO)、肺功能、呼吸道感染次数、哮喘急性发作次数及儿童哮喘控制测试(C-ACT)评分。结果 哮喘组TGF-β1、Smad3表达水平高于对照组,差异有统计学意义(P<0.05)。B组治疗3个月呼吸道感染次数、哮喘急性发作次数较A组明显减少,C-ACT评分较较A组升高(P<0.05)。治疗1个月、3个月,A、B两组患儿血清TGF-β1、Smad3及FeNO水平较治疗前下降(P<0.05),第1秒用力呼气量占预计值百分比(FEV1%)、呼气流速峰值占预计值百分比(PEF%)、用力呼50%肺活量的瞬间流量占预计值百分比(FEF50%)、 用力呼75%肺活量的瞬间流量占预计值百分比(FEF75%)、最大呼气中期流量占预计值百分比(MMEF75/25%)较治疗前升高(P<0.05),且同时间点A、B组比较差异有统计学意义(P<0.05)。结论 轻度持续期哮喘患儿血清TGF-β1、Smad3水平明显增高。在单纯吸入性糖皮质激素治疗下加用维生素D可降低TGF-β1、Smad3的表达水平,同时减少哮喘急性发作次数,减轻气道炎症,改善肺功能,进一步提高临床治疗效果。Abstract: Objective To explore the expression of transforming growth factor β1 (TGF-β1) and Smad3 in children with asthma and the efficacy of vitamin D as an adjunct therapy in the treatment of pediatric asthma. Methods A total of 120 children with mild persistent asthma, who were treated at the Affiliated Hospital of Xuzhou Medical University from April 2022 to June 2023, were selected as an asthma group. Additionally, 80 healthy children undergoing physical examinations during the same period at the hospital were selected as a control group. The serum levels of TGF-β1 and Smad3 were compared between the two groups. According to the random number table method, the asthma group was divided into group A and group B (n=60). The serum levels of 25(OH)D, TGF-β1, Smad3, fractional exhaled nitric oxide (FeNO), lung function, frequency of respiratory infections, frequency of acute asthma exacerbations, and Childhood Asthma Control Test (C-ACT) scores were compared between groups A and B before treatment, and at 1 month and 3 months after treatment. Results The levels of TGF-β1 and Smad3 in the asthma group were significantly higher than those in the control group (P<0.05). After 3 months of treatment, group B showed a significant reduction in the frequency of respiratory infections and acute asthma exacerbations, and increased C-ACT scores compared with group A (P<0.05). At 1 month and 3 months after treatment, the levels of serum TGF-β1, Smad3, and FeNO in both groups decreased compared with those before treatment (P<0.05). The percentage of predicted forced expiratory volume in the first second (FEV1%), peak expiratory flow (PEF%), forced expiratory flow at 50% of forced vital capacity (FEF50%), forced expiratory flow at 75% of forced vital capacity (FEF75%), and maximum mid-expiratory flow (MMEF75/25%) increased compared with those before treatment (P<0.05), with greater improvements observed in group B than in group A (P<0.05). Conclusions The levels of serum TGF-β1 and Smad3 are significantly elevated in children with mild persistent asthma. The addition of vitamin D to standard inhaled corticosteroid treatment can reduce the expression of TGF-β1 and Smad3, decrease the frequency of acute asthma exacerbations, alleviate airway inflammation, and improve lung function, thereby enhancing clinical therapeutic efficacy.
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Keywords:
- bronchial asthma /
- vitamin D /
- pulmonary function /
- airway remodeling /
- TGF-β1 /
- Smad3
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