Effect of omalizumab on the balance of Th1/Th2 cytokines in 105 cases with elderly bronchial asthma

doi:10.3877/cma.j.issn.1674-6902.2026.03.016

Abstract

Abstract:

Objective

To evaluate the effect of omalizumab on the balance of helper T cell 1 (Th1)/Th2 cytokines and its clinical efficacy in elderly patients with bronchial asthma.

Methods

A total of 105 elderly patients with bronchial asthma treated at The First People′s Hospital of Xianyang from September 2021 to October 2024 were enrolled and assigned to an observation group 48 cases, receiving conventional inhalation therapy plus subcutaneous injection of omalizumab or a control group 57 cases, receiving conventional inhalation therapy alone based on treatment preference (non-randomized design). The treatment duration was 12 weeks. Clinical efficacy, peripheral blood Th1-type cytokines [interferon-gamma (IFN-γ), interleukin-2 (IL-2)], Th2-type cytokines (IL-4, IL-13), inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), IL-6, tumor necrosis factor-alpha (TNF-α)], total immunoglobulin E (IgE), lung function parameters [forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), maximum mid-expiratory flow (MMEF), FEV₁/FVC ratio], and adverse events were compared between the two groups.

Results

The observation group had higher total effective rate [87.50%(42/48) vs. (70.18%, 40/57)] (P<0.05). After treatment , the observation group had higher IFN-γ and IL-2 [(29.63±6.78) pg/ml and (15.66±4 .42)pg/ml vs. (21.22±5.19)pg/ml and (11.57±3.09)pg/ml], while lower levels of IL-4 and IL-13 [(18.57±4.13) pg/ml and (19.48±4.87)pg/ml vs. (23.99±5.64)pg/ml and (25.22±5.38)pg/ml] (P<0.05); the observation group showed a decreasing trend of hs-CRP(12.27±2.65) mg/L, IL-6 (41.31±8.18) pg/ml, TNF-α(28.44±7.76) pg/ml, and total IgE (181.57±43.82)IU/ml, and those in the observation group were lower [(16.22±3.82) mg/L, (50.46±9.49)pg/ml, (37.68±8.93) pg/ml, (225.46±59.23)IU/ml] (P<0.05); the observation group had higher FEV₁(1.47±0.35)L, FVC(2.36±0.46)L, MMEF (1.31±0.36) L/s, FEV₁/FVC (66.39±5.42)% vs. (1.34±0.36)L, (2.15±0.47)L, (1.08±0.31)L/s, (62.46±5.65)% (P<0.05). The observation group had higher incidence of adverse reactions (14.58% vs. 8.77%), without statistically significant difference (P>0.05).

Conclusions

In elderly patients with bronchial asthma, addition of omalizumab to conventional therapy can restore the Th1/Th2 cytokine balance, reduce systemic inflammation and IgE levels, and improve lung function, with an acceptable safety profile.

Key words: Bronchial asthma, Elderly, Omalizumab, Th1/Th2 balance, Inflammatory state, Lung function, Allergic asthma, Immune imbalance

Xin Lei, Yiyuan Li, Mei Zhai. Effect of omalizumab on the balance of Th1/Th2 cytokines in 105 cases with elderly bronchial asthma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(03): 459-463.

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References 29

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组　别	例数	IFN-γ(pg/ml)		IL-2(pg/ml)		IL-4(pg/ml)		IL-13(pg/ml)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	15.69±3.18	29.63±6.78^a	8.29±2.11	15.66±4.42^a	32.38±6.27	18.57±4.13 ^a	33.59±6.72	19.48±4.87^a
对照组	57	15.77±3.23	21.22±5.19^a	8.34±2.15	11.57±3.09^a	31.44±6.21	23.99±5.64^a	34. 66±7.25	25.22±5.38^a
t值		0.127	7.193	0.120	5.559	0.769	5.525	0.779	5.686
P值		0.899	0.000	0.905	0.000	0.443	0.000	0.438	0.000

组　别	例数	IFN-γ(pg/ml)		IL-2(pg/ml)		IL-4(pg/ml)		IL-13(pg/ml)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	15.69±3.18	29.63±6.78^a	8.29±2.11	15.66±4.42^a	32.38±6.27	18.57±4.13 ^a	33.59±6.72	19.48±4.87^a
对照组	57	15.77±3.23	21.22±5.19^a	8.34±2.15	11.57±3.09^a	31.44±6.21	23.99±5.64^a	34. 66±7.25	25.22±5.38^a
t值		0.127	7.193	0.120	5.559	0.769	5.525	0.779	5.686
P值		0.899	0.000	0.905	0.000	0.443	0.000	0.438	0.000

组　别	例数	hs-CRP(mg/L)		IL-6(pg/ml)		TNF-α(pg/ml)		总IgE(IU/ml)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	23.18±5.89	12. 27±2.65^a	65.82±12.83	41.31±8.18^a	58.87±11.34	28.44±7.76^a	296. 27±68.12	181.57±43.82^a
对照组	57	23.56±5 .47	16. 22±3.82^a	66.77±12.56	50.46±9.49^a	57.93±12.28	37.68±8.93^a	298.35±67.46	225.46±59.23^a
t值		0.342	6.011	0.390	5.227	0.417	5.592	0.160	4.246
P值		0.733	0.000	0.697	0.000	0.677	0.000	0.873	0.000

组　别	例数	hs-CRP(mg/L)		IL-6(pg/ml)		TNF-α(pg/ml)		总IgE(IU/ml)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	23.18±5.89	12. 27±2.65^a	65.82±12.83	41.31±8.18^a	58.87±11.34	28.44±7.76^a	296. 27±68.12	181.57±43.82^a
对照组	57	23.56±5 .47	16. 22±3.82^a	66.77±12.56	50.46±9.49^a	57.93±12.28	37.68±8.93^a	298.35±67.46	225.46±59.23^a
t值		0.342	6.011	0.390	5.227	0.417	5.592	0.160	4.246
P值		0.733	0.000	0.697	0.000	0.677	0.000	0.873	0.000

组　别	例数	FEV₁(L)		FVC(L)		MMEF(L/s)		FEV₁/FVC(%)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	48	1.25±0. 33	1.47±0. 35^a	2.08±0.44	2.36±0.46^a	0.92±0.19	1.31±0.36^a	61.14±5.65	66. 39±5.42^a
对照组	57	1.27±0.34	1.34±0.36	2.11±0.45	2.15±0.47	0.88±0.20	1.08±0.31^a	61.25±5.78	62.46±5.65
t值		0.152	2.154	0.115	2.084	0.522	3.824	0.071	3.617
P值		0.879	0.034	0.909	0.040	0.603	0.000	0.943	0.000

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