Predictive significance of combined detection of serum biomarkers in effect of biological targeted therapy on children with bronchial asthma

doi:10.3877/cma.j.issn.1674-6902.2025.05.024

Abstract

Abstract:

Objective

To analyze the predictive significance of combined serum biomarker testing for biological targeted therapy in children with bronchial asthma (BA).

Methods

A total of 64 children with BA admitted to our hospital from March 2022 to April 2025 were selected. Based on the efficacy after 16 weeks of omalizumab treatment, they were divided into two groups: 48 effective cases as the observation group and 16 ineffective cases as the control group. Clinical data, forced expiratory volume in one second (FEV₁), forced expiratory volume in one second/forced vital capacity ratio (FEV₁/FVC), peak expiratory flow (PEF), and serum biomarkers including immunoglobulin E (IgE), interleukin (IL)-4, IL-6, IL-17A, and IL-2R were compared between the two groups. Logistic regression analysis was used to identify factors influencing the responsiveness of BA children to biological targeted therapy, and receiver operating characteristic (ROC) curves were plotted to evaluate predictive value.

Results

In the observation group, 23 cases (47.92%) had mild disease, and FEV₁ (94.42±8.54)% was higher than that in the control group [3 cases (18.75%), FEV₁ (81.53±5.65)%]. Total IgE (1 102.9±292.5)IU/ml, IL-4 (8.86±2.02)pg/ml, IL-6(8.95±2.37)pg/ml, IL-17A(8.62±2.31)pg/ml, and IL-2R(164.64±54.16)U/ml in the observation group were lower than those in the control group total IgE (1 677.7±527.9)IU/ml, IL-4 (12.78±3.54)pg/ml, IL-6 (10.64±3.15)pg/ml, IL-17A (13.39 ± 4.45)pg/ml, IL-2R (248.54±75.39)U/ml (P<0.05). Logistic regression analysis showed that disease severity (OR=0.358, 95%CI=0.127~1.006), FEV₁(OR=1.238, 95%CI=1.102~1.392), serum total IgE (OR=0.980, 95%CI: 1.102~1.392), IL-2R(OR=0.974, 95%CI: 0.954~0.994), and IL-4(OR=0.617, 95%CI: 0.402~0.947) were influencing factors for biological targeted therapy in children with BA. ROC curve analysis revealed that the area under the curve (AUC) for the combined prediction of serum total IgE, IL-4, and IL-2R for biological targeted therapy in children with BA was 0.896 (95%CI=0.906~0.999), which was higher than the AUCs for individual predictions of serum total IgE (0.683, 95%CI=0.703~0.904), IL-4 (0.654, 95%CI: 0.722~0.917), and IL-2R (0.642, 95%CI: 0.676~0.886).

Conclusion

Serum levels of IgE, IL-4, and IL-2R are negatively correlated with the efficacy of biological targeted therapy in children with BA. The combined prediction of serum IgE, IL-4, and IL-2R holds clinical significance for biological targeted therapy in children with BA.

Key words: Bronchial asthma, Biological targeted therapy, Serum biomarkers, Therapeutic effect prediction

Lihui Liu, Yuxin Bai, Jin Zhang, Wei Feng, Yanyan Huang, Mengsi Zou, Caihong Liu. Predictive significance of combined detection of serum biomarkers in effect of biological targeted therapy on children with bronchial asthma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2025, 18(05): 796-801.

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References 30

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临床资料	观察组(n＝48)	对照组(n＝16)	t/χ²值	P值
FEV₁(%)	94.42±8.54	81.53±5.65	6.876	0.000
FEV₁/FVC	84.23±9.15	78.89±10.58	1.806	0.085
PEF(%)	80.42±11.63	75.56±10.23	1.589	0.123
总IgE(IU/ml)	1 102.9±292.5	1 677.7±527.9	4.147	0.001
IL-4(pg/ml)	8.86±2.02	12.78±3.54	4.207	0.001
IL-6(pg/ml)	8.95±2.37	10.64±3.15	1.968	0.063
IFN-γ(pg/ml)	12.54±1.62	13.81±2.65	1.808	0.087
IL-17A(pg/ml)	8.62±2.31	13.39±4.45	4.107	0.001
IL-1β(pg/ml)	4.61±1.03	5.34±1.59	1.720	0.102
IL-2(pg/ml)	7.87±1.53	8.25±1.68	0.801	0.431
IL-2R(U/ml )	164.64±54.16	248.54±75.39	4.112	0.001
IL-8(pg/ml )	19.54±4.12	21.91±4.96	1.723	0.099
TNF-α(pg/ml )	10.43±1.56	12.87±5.29	1.819	0.089

临床资料	观察组(n＝48)	对照组(n＝16)	t/χ²值	P值
FEV₁(%)	94.42±8.54	81.53±5.65	6.876	0.000
FEV₁/FVC	84.23±9.15	78.89±10.58	1.806	0.085
PEF(%)	80.42±11.63	75.56±10.23	1.589	0.123
总IgE(IU/ml)	1 102.9±292.5	1 677.7±527.9	4.147	0.001
IL-4(pg/ml)	8.86±2.02	12.78±3.54	4.207	0.001
IL-6(pg/ml)	8.95±2.37	10.64±3.15	1.968	0.063
IFN-γ(pg/ml)	12.54±1.62	13.81±2.65	1.808	0.087
IL-17A(pg/ml)	8.62±2.31	13.39±4.45	4.107	0.001
IL-1β(pg/ml)	4.61±1.03	5.34±1.59	1.720	0.102
IL-2(pg/ml)	7.87±1.53	8.25±1.68	0.801	0.431
IL-2R(U/ml )	164.64±54.16	248.54±75.39	4.112	0.001
IL-8(pg/ml )	19.54±4.12	21.91±4.96	1.723	0.099
TNF-α(pg/ml )	10.43±1.56	12.87±5.29	1.819	0.089

自变量	β	标准误	Wald	P值	OR	95%CI
自变量	β	标准误	Wald	P值	OR	下限	上限
病情严重程度	－1.027	0.527	3.797	0.041	0.358	0.127	0.506
FEV₁	0.214	0.060	12.829	0.000	1.238	1.102	1.392
总IgE	－0.020	0.013	2.443	0.018	0.980	0.856	0.995
IL-2R	－0.027	0.011	6.294	0.012	0.974	0.954	0.994
IL-4	－0.483	0.219	4.889	0.027	0.617	0.402	0.947
IL-17A	－0.190	0.270	0.491	0.483	0.827	0.487	1.406
常量	21.402	6.909	9.595	0.002

自变量	β	标准误	Wald	P值	OR	95%CI
自变量	β	标准误	Wald	P值	OR	下限	上限
病情严重程度	－1.027	0.527	3.797	0.041	0.358	0.127	0.506
FEV₁	0.214	0.060	12.829	0.000	1.238	1.102	1.392
总IgE	－0.020	0.013	2.443	0.018	0.980	0.856	0.995
IL-2R	－0.027	0.011	6.294	0.012	0.974	0.954	0.994
IL-4	－0.483	0.219	4.889	0.027	0.617	0.402	0.947
IL-17A	－0.190	0.270	0.491	0.483	0.827	0.487	1.406
常量	21.402	6.909	9.595	0.002

自变量	AUC	95%CI	敏感性	特异性	约登指数
总IgE	0.819	0.703~0.904	87.50	70.83	0.683
IL-4	0.836	0.722~0.917	81.25	65.42	0.654
IL-2R	0.796	0.676~0.886	62.50	61.70	0.642
联合	0.978	0.906~0.999	89.58	90.00	0.896

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