[1]许银辉,赵青.基于GSDMD信号通路介导的细胞焦亡探讨布地奈德联合孟鲁司特对支气管哮喘患儿的治疗效果[J].陕西医学杂志,2026,(6):826-831.[doi:DOI:10.3969/j.issn.1000-7377.2026.06.018]
 XU Yinhui,ZHAO Qing.Therapeutic effect of budesonide combined with montelukast in children with bronchial asthma based on GSDMD signaling pathway-mediated pyroptosis[J].,2026,(6):826-831.[doi:DOI:10.3969/j.issn.1000-7377.2026.06.018]
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基于GSDMD信号通路介导的细胞焦亡探讨布地奈德联合孟鲁司特对支气管哮喘患儿的治疗效果

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年6期
页码:
826-831
栏目:
药物与临床
出版日期:
2026-06-05

文章信息/Info

Title:
Therapeutic effect of budesonide combined with montelukast in children with bronchial asthma based on GSDMD signaling pathway-mediated pyroptosis
作者:
许银辉赵青
(上海复旦大学附属中山医院青浦分院儿科,上海 201700)
Author(s):
XU YinhuiZHAO Qing
(Department of Pediatrics,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700,China)
关键词:
支气管哮喘消皮素D孟鲁司特肺功能细胞焦亡儿童
Keywords:
Bronchial asthmaGasdermin DMontelukastLung functionPyroptosisChildren
分类号:
R 562.25
DOI:
DOI:10.3969/j.issn.1000-7377.2026.06.018
文献标志码:
A
摘要:
目的:基于消皮素D(GSDMD)信号通路介导的细胞焦亡探讨布地奈德联合孟鲁司特对支气管哮喘患儿的治疗效果。方法:选取86例支气管哮喘患儿作为研究对象,采用随机、双盲、对照试验设计将患儿随机均分为孟鲁司特组和对照组。对照组采用布地奈德治疗,观察组采用布地奈德联合孟鲁司特钠咀嚼片治疗。两组均连续治疗1个月。治疗前后检测一秒用力呼气容积(FEV1)、用力肺活量(FVC)、峰值呼气流速(PEF)、肺一氧化碳弥散量(DLCO)、残气量/肺总量比值(RV/TLC)以及FEV1/FVC。采用酶联免疫吸附试验(ELISA)检测血清GSDMD、白细胞介素-1β(IL-1β)、IL-18蛋白水平。通过透射电子显微镜观察外周血单个核细胞(PBMCs)焦亡形态。记录喘息、喘息性啰音、咳嗽和呼吸困难消失时间。结果:在治疗前,两组FEV1、FVC、PEF、DLCO、RV/TLC、FEV1/FVC以及血清GSDMD、IL-1β、IL-18蛋白水平比较无统计学差异(均P>0.05)。治疗1个月后,两组FEV1、FVC、PEF、DLCO、RV/TLC、FEV1/FVC以及血清GSDMD、IL-1β、IL-18蛋白水平均有改善,且孟鲁司特组优于对照组(均P<0.05)。透射电子显微镜观察显示,对照组PBMCs出现明显肿胀、细胞膜破裂及细胞器空泡化等焦亡典型特征,而孟鲁司特组细胞形态基本正常。与对照组比较,孟鲁司特组喘息、喘息性啰音、咳嗽、呼吸困难消失时间较短(均P<0.05)。相关性分析结果显示,治疗后两组患儿血清GSDMD水平与FVC、PEF、RV/TLC、FEV1、FEV1/FVC呈负相关性,IL-1β水平与FVC、RV/TLC、FEV1、FEV1/FVC呈负相关性,IL-18水平与PEF、RV/TLC呈负相关性(均P<0.05)。结论:联合使用布地奈德和孟鲁司特钠治疗可以显著改善支气管哮喘患儿的肺功能,抑制外周GSDMD信号通路介导的细胞焦亡,并促进喘息、咳嗽症状康复。
Abstract:
Objective:To explore the therapeutic effect of budesonide combined with montelukast in children with bronchial asthma based on pyroptosis mediated by Gasdermin D (GSDMD) signaling pathway.Methods:A total of 86 children with bronchial asthma were selected as the research subjects.A randomized,double-blind,controlled trial design was adopted to randomly and evenly divide the children into the montelukast group and the control group.The control group was treated with budesonide,while the observation group was treated with budesonide combined with montelukast sodium chewable tablets.Both groups were treated continuously for 1 month.Before and after treatment,FEV1,FVC,PEF,DLCO,RV/TLC,and FEV1/FVC were measured.The levels of GSDMD,IL-1β,and IL-18 proteins in serum were detected by ELISA.The pyroptosis morphology of PBMCs was observed by transmission electron microscopy.The disappearance time of wheezing,wheezing rales,cough,and dyspnea was recorded.Results:Before treatment,there was no statistically significant difference in FEV1,FVC,PEF,DLCO,RV/TLC,FEV1/FVC,and serum GSDMD,IL-1β,and IL-18 protein levels between the two groups (all P>0.05).After 1 month of treatment,FEV1,FVC,PEF,DLCO,RV/TLC,FEV1/FVC,and serum GSDMD,IL-1β,and IL-18 protein levels in both groups improved,and the montelukast group showed better improvement than the control group (all P<0.05).Transmission electron microscopy observations revealed that the PBMCs in the control group showed typical features of pyroptosis,such as obvious swelling,cell membrane rupture,and vacuolation of organelles,while the cell morphology in the montelukast group was basically normal.Compared with the control group,the disappearance time of wheezing,wheezing rales,cough,and dyspnea in the montelukast group was shorter (all P<0.05)).Correlation analysis results showed that after treatment,the serum GSDMD level was negatively correlated with FVC,PEF,RV/TLC,FEV1,and FEV1/FVC,the IL-1β level was negatively correlated with FVC,RV/TLC,FEV1,and FEV1/FVC,and the IL-18 level was negatively correlated with PEF and RV/TLC (all P<0.05).Conclusion:The combined use of budesonide and montelukast sodium can significantly improve the lung function of children with bronchial asthma,inhibit the pyroptosis mediated by the peripheral GSDMD signaling pathway,and promote the recovery of wheezing and cough symptoms.

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备注/Memo

备注/Memo:
上海市卫生健康委员会科研项目(20231631)
更新日期/Last Update: 2026-06-05