[Relationship between serum 25-hydroxyl-vitamin D3 levels and galectin-3 levels in serum and bronchoalveolar lavage fluid in children with asthma].

OBJECTIVE: To investigate the changes of the levels of galectin-3 (Gal-3) in serum and bronchoalveolar lavage fluid (BALF) of children with asthma whose have different serum levels of 25-hydroxyl-vitamin D3[25(OH)D3]. METHODS: Fifty children with asthma between January 2013 and December 2014 were enrolled as the asthma group, and they were classified into 25(OH)D3sufficient (n=7), insufficient (n=12) and deficient subgroups (n=31) according to the serum levels of 25(OH)D3. Twenty children with abnormal airway or tracheal foreign bodies served as the control group. The levels of 25(OH)D3, Gal-3 and total IgE in serum and Gal-3 levels in BALF were measured using ELISA. RESULT: The serum levels of 25(OH)D3in the asthma group were lower than in the control group (P<0.05). The 25(OH)D3deficient subgroup displayed the highest percentages of neutrophils, eosinophils and epithelial cells in BALF, followed by the 25(OH)D3insufficient subgroup and the 25(OH)D3sufficient subgroup (P<0.05). The percentages of neutrophils, eosinophils and epithelial cells in BALF in the three subgroups were all higher than in the control group (P<0.05). In children with asthma, serum levels of 25(OH)D3were negatively correlated with the percentages of neutrophils, eosinophils and epithelial cells in BALF (r=-0.683, -0.795 and -0.670 respectively; P<0.05); and a negative correlation was also seen between serum 25(OH)D3levels and serum Gal-3 and total IgE levels (r=-0.759 and -0.875 respectively; P<0.05). CONCLUSIONS: The children with asthma have low serum levels of 25(OH)D3. 25(OH)D3and Gal-3 may be involved in the airway inflammation and the development of asthma.

[Etiology, clinical features, and diagnosis and treatment of recurrent hemoptysis in children].

OBJECTIVE: To investigate the causes, clinical features, therapy and treatment outcomes of recurrent hemoptysis in children and to improve the skills of pediatricians in the etiological diagnosis and treatment of recurrent hemoptysis in children. METHODS: The clinical, laboratory, and imaging data of 39 children with recurrent hemoptysis between January 1996 and February 2013 were collected to retrospectively analyze the age of onset, etiology, amount of hemoptysis, imaging changes, treatment methods, and follow-up outcomes. RESULTS: In the 39 children, including idiopathic pulmonary hemosiderosis (16 cases, 41%), pulmonary vascular malformation (8 cases, 21%), pulmonary arteriovenous fistula (7 cases, 18%), bronchiectasis (3 cases, 8%), pulmonary tuberculosis (2 cases, 5%), pulmonary cystic fibrosis (2 cases, 5%), and lung tumor (1 case, 3%). The contrast-enhanced lung CT scans and pulmonary and bronchial arteriography revealed varying degrees of lung imaging changes in 35 cases. Of all cases, 51% were classified as degree I, 28% as degree II, and 21% as degree III. All children were treated according to the etiology, with the disease controlled. During 0.5-5 years of follow-up, 3 patients with idiopathic pulmonary hemosiderosis were lost to follow-up, and the other cases did not develop hemoptysis again. CONCLUSIONS: Idiopathic pulmonary hemosiderosis is the main cause of recurrent hemoptysis in children. Contrast-enhanced lung CT scans and pulmonary and bronchial arteriography are important methods for the etiological diagnosis of recurrent hemoptysis in children. Treatment methods should be selected according to the etiology.

Dexamethasone reduces IL-17 and Tim-3 expression in BALF of asthmatic mice.

This study investigated the expression of interleukin-17 (IL-17) and T cell immunoglobulin mucin and domain-containing molecule-3 (Tim-3) in bronchoalveolar lavage fluid (BALF) of asthmatic mice and the effect of dexamethasone (DEX) on these factors. Thirty-six mice were randomly divided into three groups: normal group, asthmatic group and DEX group. The mouse model of asthma was established by sensitization with ovalbumin in both the asthmatic and DEX groups. The levels of IL-6, IL-10, IL-17 and TGF-ß were measured in BALF by enzyme-linked immunesorbent assay (ELISA). The mRNA expression level of Tim-3 was detected by reverse transcription polymerase chain reaction (RT-PCR). The ratio of Tim-3+CD4+ cells to total CD4+ cells in BALF was determined by flow cytometry. Differential inflammatory cells in BALF were detected. The correlations among IL-17, IL-6, IL-10, Tim-3 and inflammatory cells were analyzed. The results showed that the levels of IL-17, IL-6 and Tim-3 were substantially increased and the IL-10 level decreased in BALF in the asthmatic mice, which was significantly reversed by DEX treatment. IL-17 expression was positively correlated with IL-6 and Tim-3 expression and the number of inflammatory cells but negatively with IL-10 expression. These results indicate that the increased expression of IL-17 and Tim-3 in BALF may be implicated in the occurrence and development of asthmatic inflammation; the mechanism by which DEX suppresses asthmatic airway inflammation involves down-regulation of IL-17 and Tim-3 levels.

[Changes in IL-17 and TGF-ß1 levels in serum and bronchoalveolar lavage fluid and their clinical significance among children with asthma].

OBJECTIVE: To investigate the changes in the levels of interleukin-17 (IL-17) and transforming growth factor beta 1 (TGF-ß1) in serum and bronchoalveolar lavage fluid (BALF) and their clinical significance among children with asthma. METHODS: Fifty-six children with asthma were divided into moderate or severe asthma (n=37) and mild asthma groups (n=19) and 18 children without asthma were selected as the control group. Cells in BALF were counted under a microscope. The levels of IL-17 and TGF-ß1 in serum and BALF were measured using ELISA. RESULTS: were no significant differences in total cell count and percentage of macrophages between the two asthma groups and the control group (P>0.05). The percentages of neutrophils, eosinophils and epithelial cells in BALF were significantly higher in the two asthma groups than in the control group (P<0.05). The two asthma groups had significantly higher levels of IL-17 and TGF-ß1 in serum and BALF than the control group (P<0.05), and the moderate or severe asthma group had significantly higher levels of IL-17 and TGF-ß1 in serum and BALF than the mild asthma group (P<0.05). Levels of IL-17 and TGF-ß1 in serum were significantly positively correlated with those in BALF (r=0.935 and 0.943, P<0.05 for both). In children with asthma, serum IL-17 level was significantly positively correlated with the percentage of neutrophils, eosinophils and epithelial cells in BALF (r=0.802, 0.799, and 0.674, P<0.05 for all), and a significant positive correlation was also seen between serum levels of IL-17 and TGF-ß1 (r=0.878, P<0.05). CONCLUSIONS: Levels of IL-17 and TGF-ß1 in serum and BALF are elevated in children with asthma. IL-17 and TGF-ß1 may be involved in the occurrence and development of asthma, and they play important roles in asthma attack and aggravation.

Small interfering RNA targeting T-cell Ig mucin-3 decreases allergic airway inflammation and hyperresponsiveness.

Since CD4+ T cells play a pivotal role in the development of airway inflammation and hyperresponsiveness, targeting activated CD4+ T cell subsets and increasing the cells with regulatory function would be a logical therapeutic approach. We showed that this outcome can be achieved by local therapy with Tim-3, which is a negative regulator of CD4+ T cells. Tim-3 expression was up-regulated by ovalbumin (OVA) induction. Attenuating Tim-3 expression by RNA interference suppressed allergen-induced immune responses. Intranasal application of Tim-3 shRNA diminished airway inflammation and hyperresponsiveness. Multiple mechanisms were involved in the inhibitory effects, including regulation the imbalance of Th1/Th17 and increasing Treg cell expression. Our results indicate that the Tim-3 pathway is highly involved in the regulation of asthma. Targeting Tim-3 by siRNA may hold therapeutic potential in preventing the development of allergic asthma.

Changes in interleukin-17 and transforming growth factor beta 1 levels in serum and bronchoalveolar lavage fluid and their clinical significance among children with asthma.

OBJECTIVES: To investigate the changes in the levels of interleukin-17 (IL-17) and transforming growth factor beta 1 (TGF-ß1) in serum and bronchoalveolar lavage fluid (BALF) and their clinical significance among children with asthma. METHODS: A total of 56 children with asthma were divided into moderate or severe asthma (n=37) and mild asthma groups (n=19) and 18 children without asthma were selected as the control group. Cells in BALF were counted under a microscope. The levels of IL-17 and TGF-ß1 in serum and BALF were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: There were no significant differences in total cell count and percentage of macrophages between the two asthma groups and the control group (P>0.05). The percentages of neutrophils, eosinophils and epithelial cells in BALF were significantly higher in the two asthma groups than in the control group (P<0.05). The two asthma groups had significantly higher levels of IL-17 and TGF-ß1 in serum and BALF than the control group (P<0.05), and the moderate or severe asthma group had significantly higher levels of IL-17 and TGF-ß1 in serum and BALF than in the mild asthma group (P<0.05). The serum levels of IL-17 and TGF-ß1 were positively correlated with those in BALF (r=0.935 and 0.943, both P<0.05). In children with asthma, serum IL-17 level was positively correlated with the percentages of neutrophils, eosinophils, and epithelial cells in BALF (r=0.802, 0.799, and 0.674, all P<0.05), and a positive correlation was also seen between serum levels of IL-17 and TGF-ß1 (r=0.878, P<0.05). CONCLUSIONS: Levels of IL-17 and TGF-ß1 in serum and BALF are elevated in children with asthma. IL-17 and TGF-ß1 may be involved in the occurrence and development of asthma, and they play important roles in asthma attack and aggravation.