[1]裔 静,康苧心,卢海波,等.慢性鼻窦炎患者血清和鼻腔分泌物中分泌型卷曲相关蛋白5 的表达水平及临床价值研究[J].现代检验医学杂志,2023,38(06):103-107+113.[doi:10.3969/j.issn.1671-7414.2023.06.019]
　YI Jing,KANG Ningxin,LU Haibo,et al.Study on the Expression Level and Clinical Value of Secretory Frizzledrelated Protein 5 in Serum and Nasal Secretions in Patients with Chronic Rhinosinusitis[J].Journal of Modern Laboratory Medicine,2023,38(06):103-107+113.[doi:10.3969/j.issn.1671-7414.2023.06.019]
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慢性鼻窦炎患者血清和鼻腔分泌物中分泌型卷曲相关蛋白5 的表达水平及临床价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年06期
页码:
103-107+113
栏目:
论著
出版日期:
2023-11-15

文章信息/Info

Title:
Study on the Expression Level and Clinical Value of Secretory Frizzledrelated Protein 5 in Serum and Nasal Secretions in Patients with Chronic Rhinosinusitis
文章编号:
1671-7414（2023）06-103-06
作者:
裔 静; 康苧心; 卢海波; 孙相波
（南通大学第四附属医院耳鼻喉科，江苏盐城 224000）
Author(s):
YI Jing;  KANG Ningxin;  LU Haibo;  SUN Xiangbo
（Department of Otorhinolaryngology, the Fourth Affiliated Hospital of Nantong University, Jiangsu Yancheng 224000, China）
关键词:
慢性鼻窦炎; 鼻腔分泌物; 分泌型卷曲相关蛋白5
分类号:
R765.41；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.06.019
文献标志码:
A
摘要:
目的 探讨慢性鼻窦炎（chronic rhinosinusitis，CRS）患者血清和鼻腔分泌物中分泌型卷曲相关蛋白5（secretoryfrizzled-related protein 5，SFRP5）的表达水平及临床价值。方法 选取2020 年7 月～ 2022 年6 月南通大学第四附属医院收治的CRS 伴鼻息肉（CRS with nasal polyps，CRSwNP）患者123 例为研究对象，根据息肉组织染色病理结果分为嗜酸性粒细胞性CRSwNP（eosinophilic CRSwNP，ECRSwNP）组（n=69）和非嗜酸性粒细胞性CRSwNP（noneosinophilicECRSwNP，nECRSwNP）组（n=54）。另选取同期体检正常的健康者55 例为对照组。酶联免疫吸附实验(enzyme linked immunosorbent assay，ELISA) 检测血清、鼻腔分泌物SFRP5 水平；多重线性回归分析CRSwNP 患者外周血嗜酸性粒细胞水平的影响因素；受试者工作特征（receiver operating characteristic，ROC）曲线评估辅助型T2（Th2）细胞、鼻腔分泌物SFRP5 及联合检测对ECRSwNP 的诊断价值。结果 ECRSwNP 组、nECRSwNP 组免疫球蛋白E（immunoglobulin E，IgE）（160.23±21.25 IU/ml，123.49±20.62 IU/ml），Th1 细胞（45.64%±5.53%，56.83%±7.20%），Th2 细胞（13.78%±3.12%，7.05%±1.47%）水平高于对照组（107.51±19.20 IU/ml，20.45%±5.06%，4.31%±0.81%），差异有统计学意义（q=20.175，5.770；33.085，45.085；34.398，9.391，均P ＜ 0.05）；ECRSwNP组IgE，Th2 细胞水平高于nECRSwNP 组，Th1 细胞水平低于nECRSwNP 组，差异有统计学意义（q=13.986，24.320，14.622，均P ＜ 0.05）。ECRSwNP 组嗜酸性粒细胞水平[0.35（0.26，0.59）×109/L] 高于nECRSwNP 组[0.15（0.09，0.18）×109/L] 和对照组[0.11（0.08，0.16）×109/L]，差异具有统计学意义（H=8.966，10.071，均P ＜ 0.05）。对照组、nECRSwNP 组和ECRSwNP 组血清SFRP5（13.08±1.74 ng/ml，9.51±1.84 ng/ml，6.72±1.26 ng/ml）、鼻腔分泌物中SFRP5 水平（24.72±3.73 ng/ml，17.64±3.09 ng/ml，9.46±2.45 ng/ml）依次降低，差异有统计学意义（F=241.18，378.074，均P ＜ 0.05）。Pearson 分析结果显示，CRSwNP 患者血清、鼻腔分泌物中SFRP5 与嗜酸性粒细胞水平呈负相关（r=-0.496，-0.601，均P ＜ 0.05）。多重线性回归显示，Th2 细胞、鼻腔分泌物SFRP5 水平为CRSwNP 患者嗜酸性粒细胞水平的主要影响因素（t=2.388，-2.993，均P ＜ 0.05）。Th2 细胞、鼻腔分泌物SFRP5 及联合检测诊断ECRSwNP 的曲线下面积（area under curve，AUC）为0.829（95%CI：0.749 ～ 0.909），0.841（95%CI：0.765 ～ 0.901）和0.905（95%CI：0.839 ～ 0.950），联合检测的AUC 高于单一指标的AUC（Z=2.012，2.100，均P ＜ 0.05）。结论 ECRSwNP 患者血清及鼻腔分泌物SFRP5 表达水平较低，Th2 细胞水平较高。鼻腔分泌物SFRP5 和Th2 细胞水平联合检测对ECRSwNP 有较高诊断价值。
Abstract:
Objective To investigate the expression of secretory frizzled-related protein 5 (SFRP5) in serum and nasal secretions of patients with chronic rhinosinusitis (CRS) and their clinical significance. Methods 123 patients with CRS with nasal polyps (CRSwNP) admitted to the Fourth Affiliated Hospital of Nantong University from July 2020 to June 2022 were selected as the study subjects. According to the stained pathological results of nasal polyps tissue, they were divided into eosinophilic CRSwNP (ECRSwNP) group (n=69) and non- eosinophilic CRSwNP (nECRSwNP) group (n=54). Another 55 healthy patients with normal physical examination in the same period were selected as the control group. Serum and nasal secretion SFRP5 levels were measured by enzyme linked immunosorbent assay(ELISA). Factors influencing peripheral blood eosinophil levels in patients with CRSwNP were analyzed by multiple linear regression. The identifying value of T helper 2 (Th2) cell, nasal secretion SFRP5 level and the combination of both on ECRSwNP was analyzed by receiver operating characteristic (ROC) curve. Results The levels of immunoglobulin E (IgE) (160.23 ± 21.25 IU/ml, 123.49 ± 20.62 IU/ml), Th1 cell (45.64% ± 5.53%, 56.83% ± 7.20%), and Th2 cell (13.78% ± 3.12%, 7.05% ± 1.47%) in ECRSwNP group and nECRSwNP group were higher than those in the control group (107.51 ± 19.20 IU/ml, 20.45% ± 5.06%, 4.31% ± 0.81%)，the differences were statistically significant (q=20.175, 5.770; 33.085, 45.085; 34.398, 9.391, all P<0.05). The levels of IgE and Th2 cell were higher than those in the nECRSwNP group, and the level of Th1 cell was lower than that in the nECRSwNP group, and the differences were statistically significant (q=13.986, 24.320, 14.622, all P<0.05). The level of eosinophils in the ECRSwNP group [0.35 (0.26, 0.59)×109/L] was higher than that in the nECRSwNP group [0.15 (0.09, 0.18)×109/L] and control group [0.11 (0.08, 0.16)×109/L], and the differences were statistically significant (H=8.966, 10.071, all P<0.05). The level of SFRP5 in serum (13.08 ± 1.74 ng/ml, 9.51 ± 1.84 ng/ml, 6.72 ± 1.26 ng/ml) and nasal secretions (24.72 ± 3.73 ng/ml, 17.64 ± 3.09 ng/ml, 9.46 ± 2.45 ng/ml) were reduced in the control group, nECRSwNP group, and ECRSwNP group in that order, and the differences were statistically significant (F=241.181, 378.074, all P<0.05). Pearson analysis showed that SFRP5 in serum and nasal secretion of CRSwNP patients was negatively correlated with eosinophil (r=-0.496, -0.601, all P<0.05). Multiple linear regression showed that Th2 cell and nasal secretion SFRP5 levels were the main influencing factors for the level of eosinophils in patients with CRSwNP (t=2.388, -2.993, all P<0.05). The area under curve (AUC) of Th2 cells, nasal secretions SFRP5, and combined detection for diagnosing ECRSwNP were 0.829 (95%CI: 0.749 ～ 0.909), 0.841 (95%CI: 0.765 ～ 0.901), and 0.905 (95%CI: 0.839 ～ 0.950), respectively. The AUC detected in combination was higher than that of a single indicator (Z=2.012, 2.100, all P<0.05). Conclusion The expression of SFRP5 in serum and nasal secretions of ECRSwNP patients was decreased, while the level of Th2 cells was elevated. The combined detection of SFRP5 and Th2 cell in nasal secretions has certain diagnostic value for ECRSwNP.

参考文献/References:

[1] KATO A, SCHLEIMER R P, BLEIER B S. Mechanisms and pathogenesis of chronic rhinosinusitis[J]. The Journal of Allergy and Clinical Immunology, 2022,149(5): 1491-1503.
[2] 朱真真, 王威清, 陈玉洁, 等. 慢性鼻窦炎伴鼻息肉复发手术时的组织病理学及外周血特征变化[J]. 中华耳鼻咽喉头颈外科杂志, 2021, 56(3): 249-255. ZHU Zhenzhen, WANG Weiqing, CHEN Yujie, et al. Changes of histopathological and hematological characteristics in recurrent chronic rhinosinusitis with nasalpolyps[J] . Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2021,56(3): 249-255.
[3] LOU Hongfei, WANG Chengshuo, ZHANG Luo. Endotype-driven precision medicine in chronic rhinosinusitis[J]. Expert Review of Clinical Immunology, 2019, 15(11): 1171-1183.
[4] BAILEY L N, GARCIA J A P, GRAYSON J W. Chronic rhinosinusitis: phenotypes and endotypes[J].Current opinion in allergy and Clinical Immunology,2021, 21(1): 24-29.
[5] JUNG H N, JUNG C H. The role of anti-inflammatory adipokines in cardiometabolic disorders: moving beyond adiponectin[J]. International Journal of Molecular Sciences, 2021, 22(24): 13529.
[6] 廖正寿, 陈东华, 鲁潜乾, 等. 支气管哮喘患者的血清分泌型卷曲相关蛋白5 与其气道炎症的相关性分析[J]. 国际呼吸杂志, 2019, 39(19): 1447-1451. LIAO Zhengshou, CHEN Donghua, LU Qianqian,et al. Correlation between serum secreted frizzledrelated protein 5 and airway inflammation in patients with bronchial asthma[J]. International Journal of Respiration, 2019, 39(19): 1447-1451.
[7] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 中国慢性鼻窦炎诊断和治疗指南（2018）[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(2):81-100. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Group of Rhinology Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Chinese guidelines for diagnosis and treatment of chronic rhinosinusitis (2018) [J].Chinese Journal Otorhinolaryngology Head and Neck Surgery, 2019, 54(2): 81-100.
[8] SOLER Z M, YOO F, SCHLOSSER R J, et al. Correlation of mucus inflammatory proteins and olfaction in chronic rhinosinusitis[J]. International Forum of Allergy & Rhinology, 2020, 10(3): 343-355.
[9] CHO S H, HAMILOS D L, HAN D H, et al. Phenotypes of chronic rhinosinusitis[J]. The Journal of Allergy and Clinical Immunology in Practice, 2020,8(5): 1505-1511.
[10] MIHALJ H, BUTKOVI? J, TOKI? S, et al. Expression of oxidative stress and inflammation-related genes in nasal mucosa and nasal polyps from patients with chronic rhinosinusitis[J]. International Journal of Molecular Sciences, 2022, 23(10): 5521.
[11] 中华医学会放射学分会头颈学组. 慢性鼻窦炎诊疗关注点及鼻窦CT 评估与结构式报告专家共识[J].中华放射学杂志, 2021, 55(3): 222-230. Head and Neck Group Chinese Society of Radiology Chinese Medical Association. Expert consensus on the focus of diagnosis and management in chronic rhinosinusitis and evaluation and structured reporting of paranasal sinus CT [J]. Chinese Journal of Radiology, 2021, 55(3): 222-230.
[12] KLINGLER A I, STEVENS W W, TAN B K, et al. Mechanisms and biomarkers of inflammatory endotypes in chronic rhinosinusitis without nasal polyps[J]. Journal of Allergy and Clinical Immunology,2021, 147(4): 1306-1317.
[13] WANG Weiqing, XU Yi, WANG Lun, et al. Singlecell profiling identifies mechanisms of inflammatory heterogeneity in chronic rhinosinusitis[J]. Nature Immunology, 2022, 23(10): 1484-1494.
[14] YAN Bing, LOU Hongfei, WANG Yang, et al. Epithelium-derived cystatin SN enhances eosinophil activation and infiltration through IL-5 in patients with chronic rhinosinusitis with nasal polyps[J]. The Journal of Allergy and Clinical Immunology, 2019, 144(2):455-469.
[15] WANG Di, ZHANG Yaping, SHEN Chengxing. Research update on the association between SFRP5, an antiinflammatory adipokine, with obesity, type 2 diabetes mellitus and coronary heart disease[J]. Journal of Cellular and Molecular Medicine, 2020, 24(5): 2730-2735.
[16] KOUTAKI D, MICHOS A, BACOPOULOU F, et al. The emerging role of Sfrp5 and Wnt5a in the pathogenesis of obesity: implications for a healthy diet and lifestyle[J]. Nutrients, 2021, 13(7): 2459.
[17] ZHANG Yi, RAN Yuxin, KONG Lingna, et al. Decreased SFRP5 correlated with excessive metabolic inflammation in polycystic ovary syndrome could be reversed by metformin: implication of its role in dysregulated metabolism[J].Journal of Ovarian Research, 2021, 14(1): 97.
[18] 吴慧, 韩文龙, 柏蕾, 等. 胎膜早破产妇血清SFRP5,TIMP-1 和HMGB1 水平与并发组织学绒毛膜羊膜炎的相关性研究[J]. 现代检验医学杂志, 2022,37(5): 112-117, 158. WU Hui, HAN Wenlong, BAI Lei, et al. Correlation of serum SFRP5, TIMP-1 and HMGB1 levels with histological chorioamnitis in pregnant women with premature rupture of membranes[J]. Journal of Modern Laboratory Medicine, 2022, 37(5): 112-117, 158.
[19] SUN Minghui, WANG Weijun, MIN Lingtian, et al. Secreted frizzled-related protein 5 (SFRP5) protects ATDC5 cells against LPS-induced inflammation and apoptosis via inhibiting Wnt5a/JNK pathway[J].Journal of Orthopaedic Surgery and Research, 2021,16(1): 129.
[20] BOCHNER B S, STEVENS W W. Biology and function of eosinophils in chronic rhinosinusitis with or without nasal polyps[J]. Allergy, Asthma & Immunology Research, 2021, 13(1): 8-22.
[21] TSUDA T, MAEDA Y, NISHIDE M, et al. Eosinophilderived neurotoxin enhances airway remodeling in eosinophilic chronic rhinosinusitis and correlates with disease severity[J]. International Immunology, 2019,31(1): 33-40.
[22] TAKABAYASHI T, SCHLEIMER R P. Formation of nasal polyps: the roles of innate type 2 inflammation and deposition of fibrin[J]. the Journal of Allergy and Clinical Immunology, 2020, 145(3): 740-750.
[23] 靳晶, 许昱. 鼻腔分泌物中生物标志物在慢性鼻窦炎内在型诊断和临床应用中的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(11): 888-892. JIN Jing, XU Yu. Research progress of biomarkers in nasal secretions in endotypes diagnosis and clinical application of chronic rhinosinusitis[J]. Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery,2022, 36(11): 888-892.

备注/Memo

备注/Memo:
基金项目：盐城市第一人民医院科研项目（YFK2019031）：鼻窦炎伴鼻息肉的转录组差异分析及功能研究。
作者简介：裔静（1985-），女，本科，主治医师，研究方向：鼻窦炎发病机制及诊断，E-mail：1052489035@qq.com。
通讯作者：孙相波（1986-），男，硕士，副主任医师，研究方向：鼻窦炎发病机制及诊断，E-mail：ent2012@163.com。
更新日期/Last Update: 2023-11-15