揭开儿童哮喘的神秘面纱:探索生物标志物、锌及其他成分

Amit Agrawal
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摘要

这篇社论讨论了 Ibrahim 等人发表在最近一期《世界临床儿科杂志》上的一项病例对照研究。儿童支气管哮喘是一种慢性炎症性呼吸道疾病。研究发现,氧化应激的增加会导致抗氧化剂的减少,从而对线粒体呼吸链复合物造成氧化损伤,导致气道炎症、粘液分泌过多,引起一连串的临床表现,从反复发作的咳嗽、喘息、呼吸困难到气短。由于氧化应激介导了哮喘的炎症反应,因此补充抗氧化剂是控制这种疾病的一种策略。锌就是这样一种抗氧化剂,它引起了人们对哮喘和气道炎症的广泛关注。锌是人体新陈代谢的重要微量元素,有助于调节基因表达、酶活性和蛋白质结构。除了锌,炎症时血清游离铁蛋白水平也会升高。之前的一些研究发现,铁蛋白水平除了能追踪疾病活动外,还有助于确定疾病的病理和预测预后。然而,这项研究的结果与之前的研究结果不同,哮喘儿童与非哮喘儿童的锌水平没有明显差异,但与对照组相比,哮喘儿童的铁蛋白水平明显偏高。因此,今后应评估包括锌和铁蛋白在内的生化营养评估作为哮喘严重程度生物标志物的可能作用。
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Unveiling childhood asthma: Exploring biomarkers, zinc, and beyond
This editorial discusses a case-control study by Ibrahim et al, published in the recent issue of the World Journal of Clinical Pediatrics . Childhood bronchial asthma is a chronic inflammatory respiratory disease. It was found that an increase in oxidative stress leads to a decrease in antioxidants causing oxidative damage to mitochondrial respiratory chain complexes resulting in the inflammation of the airway, hypersecretion of mucus causing a cascade of clinical manifestations ranging from recurrent episodes of coughing, wheezing, and breathlessness to shortness of breath. Since oxidative stress mediates the inflammatory response in asthma, the supplementation of anti-oxidants can be one strategy to manage this disease. Zinc is one such antioxidant that has attracted much attention about asthma and airway inflammation. Zinc is a crucial trace element for human metabolism that helps to regulate gene expression, enzyme activity, and protein structure. Apart from zinc, free serum ferritin levels are also elevated in case of inflammation. Several previous studies found that ferritin levels may also help determine the pathology of disease and predict prognosis in addition to tracking disease activity. However, this study's results were different from the findings of the previous studies and the zinc levels did not show a significant difference between asthmatic children and non-asthmatic children but ferritin levels were significantly high in asthmatic children as compared to the controls. Hence, the possible role of the biochemical nutritional assessment including zinc and ferritin as biomarkers for asthma severity should be assessed in the future.
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