循环白细胞介素-11在过敏性与非过敏性气道疾病表型中的研究：一项单中心探索性研究

文献信息

中文摘要

背景： 白细胞介素-11（IL-11）被认为与上皮功能障碍、成纤维细胞活化、组织重塑和慢性炎症反应有关；然而，循环IL-11在气道疾病中的临床价值仍不确定。方法：这项单中心回顾性探索性观察性研究纳入88名成人：31例过敏性鼻炎、15例非过敏性哮喘、22例与过敏性鼻炎相关的过敏性哮喘，以及20名健康对照。采用定量夹心酶联免疫吸附试验测定血清IL-11浓度。组间差异采用Kruskal-Wallis检验，随后进行Holm校正的成对Mann-Whitney U检验。采用Spearman秩相关评估其与疾病特异性有序临床分类的关联，哮喘表型使用GINA治疗步骤，过敏性鼻炎使用ARIA严重程度分类。结果：IL-11浓度中位数在非过敏性哮喘中为62.01 pg/mL，在过敏性鼻炎中为78.87 pg/mL，在与过敏性鼻炎相关的过敏性哮喘中为61.92 pg/mL，在健康对照中为95.46 pg/mL。主要全局比较无统计学显著性（H = 5.667，p = 0.129），Holm校正后没有任何成对比较仍具有显著性。6次测量（6.8%）低于检测限；在敏感性分析中将这些值替换为4.0 pg/mL并未实质性改变全局结果（H = 5.671，p = 0.129）。血清IL-11与非过敏性哮喘（rho = -0.170，p = 0.544）或与过敏性鼻炎相关的过敏性哮喘（rho = 0.052，p = 0.818）中的GINA治疗步骤无显著关联，也与过敏性鼻炎中的ARIA严重程度分类无显著关联（rho = 0.046，p = 0.805）。在一项校正年龄、性别、体重类别和当前吸烟状况的探索性分析中，各临床表型的IL-11浓度均低于健康对照；鉴于各组样本量有限且基线不平衡，该发现被视为假设生成性。结论：总体而言，主要分析未显示研究组之间循环IL-11存在显著差异，且血清IL-11与疾病特异性有序临床分类无关。这些发现不支持将单次血清IL-11测量作为该队列中气道疾病表型或临床分类的独立生物标志物，并需要在更大规模、前瞻性表征的队列中加以确认。

英文摘要

Interleukin-11 (IL-11) is implicated in epithelial dysfunction, fibroblast activation, tissue remodeling, and chronic inflammatory responses; however, the clinical value of circulating IL-11 in airway disease remains uncertain. This single-center retrospective exploratory observational study included 88 adults: 31 with allergic rhinitis, 15 with non-allergic asthma, 22 with allergic asthma associated with allergic rhinitis, and 20 healthy controls. Serum IL-11 concentrations were measured using a quantitative sandwich enzyme-linked immunosorbent assay. Between-group differences were assessed using the Kruskal-Wallis test followed by Holm-adjusted pairwise Mann-Whitney U tests. Associations with disease-specific ordinal clinical categories were evaluated using Spearman rank correlation, with GINA treatment Steps used for asthma phenotypes and ARIA severity categories for allergic rhinitis. Median IL-11 concentrations were 62.01 pg/mL in non-allergic asthma, 78.87 pg/mL in allergic rhinitis, 61.92 pg/mL in allergic asthma associated with allergic rhinitis, and 95.46 pg/mL in healthy controls. The primary global comparison was not statistically significant (H = 5.667, p = 0.129), and no pairwise comparison remained significant after Holm correction. Six measurements (6.8%) were below the assay detection limit; replacing these values with 4.0 pg/mL in a sensitivity analysis did not materially alter the global result (H = 5.671, p = 0.129). Serum IL-11 was not significantly associated with GINA treatment step in non-allergic asthma (rho = -0.170, p = 0.544) or allergic asthma associated with allergic rhinitis (rho = 0.052, p = 0.818), nor with ARIA severity category in allergic rhinitis (rho = 0.046, p = 0.805). In an exploratory analysis adjusted for age, sex, body-mass category, and current smoking status, IL-11 concentrations were lower in each clinical phenotype relative to healthy controls; given the modest group sizes and baseline imbalance, this finding was considered hypothesis-generating. Overall, the primary analysis did not demonstrate significant differences in circulating IL-11 across study groups, and serum IL-11 was not associated with disease-specific ordinal clinical categories. These findings do not support the use of a single serum IL-11 measurement as a stand-alone biomarker of airway disease phenotype or clinical category in this cohort and warrant confirmation in larger, prospectively characterized cohorts.