Dysregulation of iron homeostasis in airways associated with persistent preschool wheezing

作者全名："Wang, Zhili; He, Yu; Li, Qinyuan; Zhao, Yan; Zhang, Guangli; Luo, Zhengxiu"

作者地址："[Wang, Zhili; He, Yu; Li, Qinyuan; Zhao, Yan] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Dept Resp Med, Minist Educ,Key Lab Child Dev & Disorders,Chongqin, Chongqing 400014, Peoples R China; [Zhang, Guangli; Luo, Zhengxiu] Chongqing Med Univ, Dept Resp Med, Childrens Hosp, Chongqing 401122, Peoples R China"

通信作者："Luo, ZX (通讯作者)，Chongqing Med Univ, Dept Resp Med, Childrens Hosp, Chongqing 401122, Peoples R China."

来源：RESPIRATORY RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001018574100003

JCR分区：Q1

影响因子：4.7

年份：2023

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Bronchoalveolar lavage; Children; Iron metabolism; Recurrent wheezing

摘要："Background Currently, there are no reliable clinical tools available to identify persistent asthma symptoms among preschool children with recurrent wheezing. We investigated iron homeostasis in the airways of preschoolers with recurrent wheezing and assessed whether iron homeostasis-related indices may reliably predict persistent wheezing. Methods Iron levels and mRNA expression levels of iron homeostasis molecules were examined in bronchoalveolar lavage samples from 89 preschoolers with recurrent wheezing and 56 controls, with a 12-month follow-up conducted. Risk factors for persistent wheezing were identified using least absolute shrinkage and selection operator and multivariate logistic regression. The addition of predictive values of iron indices to the modified Asthma Predictive Index (mAPI) or clinical predictors was determined using area under receiver operating characteristic curves (AUC). Results Preschoolers with recurrent wheezing had reduced iron levels in their airways, associated with significantly decreased expression of iron export molecule SLC40A1 and increased expression of iron intake factor TFR1 and iron storage factors FTH and FTL. Risk factors for persistent wheezing included mAPI positivity, iron predictors (lower expression of SLC40A1 and higher expression of FTL), and clinical predictors (aeroallergen sensitivity, shorter breast-feeding duration, and earlier age of first wheezing episode). The addition of information on iron predictors significantly enhanced the power of clinical predictors (AUC: 84%, increase of 12%) and mAPI (AUC: 81%, increase of 14%). Conclusions Iron homeostasis is altered in the airways of preschoolers with recurrent wheezing. Adding information on iron-related indices to clinical information significantly improves accurate prediction of persistent wheezing in preschool-aged children."

基金机构："National Clinical Research Center for Child Health and Disorders (Children's Hospital of Chongqing Medical University, Chongqing, China) [NCRCCHD-2020-GP-05]; National Key Clinical Specialty Discipline Construction Program of China [2011873]"

基金资助正文："The present study was supported by grants from National Clinical Research Center for Child Health and Disorders (Children's Hospital of Chongqing Medical University, Chongqing, China) (NCRCCHD-2020-GP-05) and National Key Clinical Specialty Discipline Construction Program of China (2011-873)."