免疫出生缺陷儿童支气管扩张症的研究进展
Research Progress of the Bronchiectasis in Children with Inborn Errors of Immunity
DOI: 10.12677/acm.2025.153746, PDF,   
作者: 田 敏, 张志勇*:重庆医科大学附属儿童医院风湿免疫科/国家儿童健康与疾病临床医学研究中心/儿童发育疾病研究教育部重点实验室/儿童感染与免疫罕见病重庆市重点实验室,重庆
关键词: 免疫出生缺陷支气管扩张儿童Inborn Errors of Immunity Bronchiectasis Children
摘要: 免疫出生缺陷(inborn errors of immunity, IEI)是一类主要由单基因变异导致免疫细胞数量和(或)功能异常的疾病,是儿童支气管扩张症的重要病因之一。支气管扩张症会严重影响IEI患儿的生长发育、生存质量及预后,相较于免疫功能正常的儿童,IEI儿童在无感染情况下病变也可能进展。早期诊断及采取积极的治疗可以预防或减缓支气管扩张症的进展。有效及改善长期结局的治疗手段对IEI患儿至关重要。本文将简述近年IEI相关支气管扩张症的研究进展。
Abstract: Inborn errors of immunity (IEI) are a group of diseases caused by single-gene mutations that lead to abnormalities in the number and (or) function of immune cells. It’s one of the main causes of bronchiectasis in children, with the condition having a significant impact on growth and development, quality of life and prognosis. In contrast to children with normal immune function, the lesions of children with IEI may also progress in the absence of infection. Early diagnosis and active treatment can prevent or slow the progression of bronchiectasis. Effective treatments with improved long-term outcomes are crucial for children with IEI. This article will briefly describe the progress of research on IEI-related bronchiectasis in recent years.
文章引用:田敏, 张志勇. 免疫出生缺陷儿童支气管扩张症的研究进展[J]. 临床医学进展, 2025, 15(3): 1330-1337. https://doi.org/10.12677/acm.2025.153746

参考文献

[1] Tangye, S.G., Al-Herz, W., Bousfiha, A., Cunningham-Rundles, C., Franco, J.L., Holland, S.M., et al. (2022) Human Inborn Errors of Immunity: 2022 Update on the Classification from the International Union of Immunological Societies Expert Committee. Journal of Clinical Immunology, 42, 1473-1507. [Google Scholar] [CrossRef] [PubMed]
[2] Anderson, J.T., Cowan, J., Condino-Neto, A., Levy, D. and Prusty, S. (2022) Health-Related Quality of Life in Primary Immunodeficiencies: Impact of Delayed Diagnosis and Treatment Burden. Clinical Immunology, 236, Article ID: 108931. [Google Scholar] [CrossRef] [PubMed]
[3] 颜密, 李渠北. 儿童支气管扩张症病因的研究进展[J]. 国际儿科学杂志, 2019, 46(12): 896-900.
[4] 刘娇, 刘恩梅, 邓昱. 182例重庆地区支气管扩张患儿临床特征及病因构成分析[J]. 临床儿科杂志, 2017, 35(8): 580-584.
[5] Brower, K.S., Del Vecchio, M.T. and Aronoff, S.C. (2014) The Etiologies of Non-CF Bronchiectasis in Childhood: A Systematic Review of 989 Subjects. BMC Pediatrics, 14, Article No. 299. [Google Scholar] [CrossRef] [PubMed]
[6] Goussault, H., Salvator, H., Catherinot, E., Chabi, M., Tcherakian, C., Chabrol, A., et al. (2019) Primary Immunodeficiency-Related Bronchiectasis in Adults: Comparison with Bronchiectasis of Other Etiologies in a French Reference Center. Respiratory Research, 20, Article No. 275. [Google Scholar] [CrossRef] [PubMed]
[7] Correa-Jimenez, O., Restrepo-Gualteros, S., Nino, G., Cunningham-Rundles, C., Sullivan, K.E., Fuleihan, R.L., et al. (2023) Respiratory Comorbidities Associated with Bronchiectasis in Patients with Common Variable Immunodeficiency in the USIDNET Registry. Journal of Clinical Immunology, 43, 2208-2220. [Google Scholar] [CrossRef] [PubMed]
[8] Syed, M.N., Kutac, C., Miller, J.M., Marsh, R., Sullivan, K.E., Cunningham-Rundles, C., et al. (2022) Risk Factors of Pneumonia in Primary Antibody Deficiency Patients Receiving Immunoglobulin Therapy: Data from the US Immunodeficiency Network (Usidnet). Journal of Clinical Immunology, 42, 1545-1552. [Google Scholar] [CrossRef] [PubMed]
[9] Schütz, K., Alecsandru, D., Grimbacher, B., Haddock, J., Bruining, A., Driessen, G., et al. (2018) Imaging of Bronchial Pathology in Antibody Deficiency: Data from the European Chest CT Group. Journal of Clinical Immunology, 39, 45-54. [Google Scholar] [CrossRef] [PubMed]
[10] Haidopoulou, K., Calder, A., Jones, A., Jaffe, A. and Sonnappa, S. (2009) Bronchiectasis Secondary to Primary Immunodeficiency in Children: Longitudinal Changes in Structure and Function. Pediatric Pulmonology, 44, 669-675. [Google Scholar] [CrossRef] [PubMed]
[11] Mills, D.R., Masters, I.B., Yerkovich, S.T., McEniery, J., Kapur, N., Chang, A.B., et al. (2024) Radiographic Outcomes in Pediatric Bronchiectasis and Factors Associated with Reversibility. American Journal of Respiratory and Critical Care Medicine, 210, 97-107. [Google Scholar] [CrossRef] [PubMed]
[12] Chalmers, J.D., Chang, A.B., Chotirmall, S.H., Dhar, R. and McShane, P.J. (2018) Bronchiectasis. Nature Reviews Disease Primers, 4, Article No. 45. [Google Scholar] [CrossRef] [PubMed]
[13] Peng, Y., Xu, A., Chen, S., Huang, Y., Han, X., Guan, W., et al. (2020) Aberrant Epithelial Cell Proliferation in Peripheral Airways in Bronchiectasis. Frontiers in Cell and Developmental Biology, 8, Article No. 88. [Google Scholar] [CrossRef] [PubMed]
[14] Gutierrez, M.J., Nino, G., Sun, D., Restrepo-Gualteros, S., Sadreameli, S.C., Fiorino, E.K., et al. (2022) The Lung in Inborn Errors of Immunity: From Clinical Disease Patterns to Molecular Pathogenesis. Journal of Allergy and Clinical Immunology, 150, 1314-1324. [Google Scholar] [CrossRef] [PubMed]
[15] Hill, D.B., Button, B., Rubinstein, M. and Boucher, R.C. (2022) Physiology and Pathophysiology of Human Airway Mucus. Physiological Reviews, 102, 1757-1836. [Google Scholar] [CrossRef] [PubMed]
[16] Long, M.B., Chotirmall, S.H., Shteinberg, M. and Chalmers, J.D. (2024) Rethinking Bronchiectasis as an Inflammatory Disease. The Lancet Respiratory Medicine, 12, 901-914. [Google Scholar] [CrossRef] [PubMed]
[17] Perea, L., Faner, R., Chalmers, J.D. and Sibila, O. (2024) Pathophysiology and Genomics of Bronchiectasis. European Respiratory Review, 33, Article ID: 240055. [Google Scholar] [CrossRef] [PubMed]
[18] Mac Aogáin, M., Narayana, J.K., Tiew, P.Y., Ali, N.A.B.M., Yong, V.F.L., Jaggi, T.K., et al. (2021) Integrative Microbiomics in Bronchiectasis Exacerbations. Nature Medicine, 27, 688-699. [Google Scholar] [CrossRef] [PubMed]
[19] Flume, P.A., Chalmers, J.D. and Olivier, K.N. (2018) Advances in Bronchiectasis: Endotyping, Genetics, Microbiome, and Disease Heterogeneity. The Lancet, 392, 880-890. [Google Scholar] [CrossRef] [PubMed]
[20] Szczawińska-Popłonyk, A., Jończyk-Potoczna, K., Kycler, Z. and Bręborowicz, A. (2012) Clinical Immunology Bronchiectasis in Children with Primary Immune Deficiency Diseases. Central European Journal of Immunology, 4, 371-377. [Google Scholar] [CrossRef
[21] 徐保平, 申昆玲, Wang Hao. 小儿支气管扩张症的病因诊断及治疗分析[J]. 中国实用儿科杂志, 2017, 32(4): 245-249.
[22] Fevang, B., Mollnes, T.E., Holm, A.M., Ueland, T., Heggelund, L., Damås, J.K., et al. (2005) Common Variable Immunodeficiency and the Complement System; Low Mannose-Binding Lectin Levels Are Associated with Bronchiectasis. Clinical and Experimental Immunology, 142, 576-584. [Google Scholar] [CrossRef] [PubMed]
[23] Montella, S., Maglione, M., Bruzzese, D., Mollica, C., Pignata, C., Aloj, G., et al. (2011) Magnetic Resonance Imaging Is an Accurate and Reliable Method to Evaluate Non‐Cystic Fibrosis Paediatric Lung Disease. Respirology, 17, 87-91. [Google Scholar] [CrossRef] [PubMed]
[24] Wu, J., Bracken, J., Lam, A., Francis, K.L., Ramanauskas, F., Chang, A.B., et al. (2021) Refining Diagnostic Criteria for Paediatric Bronchiectasis Using Low-Dose CT Scan. Respiratory Medicine, 187, Article ID: 106547. [Google Scholar] [CrossRef] [PubMed]
[25] Brody, A. and Chang, A. (2017) The Imaging Definition of Bronchiectasis in Children: Is It Time for a Change? Pediatric Pulmonology, 53, 6-7. [Google Scholar] [CrossRef] [PubMed]
[26] Tiddens, H.A.W.M., Meerburg, J.J., van der Eerden, M.M. and Ciet, P. (2020) The Radiological Diagnosis of Bronchiectasis: What’s in a Name? European Respiratory Review, 29, Article ID: 190120. [Google Scholar] [CrossRef] [PubMed]
[27] Chang, A.B., Fortescue, R., Grimwood, K., Alexopoulou, E., Bell, L., Boyd, J., et al. (2021) European Respiratory Society Guidelines for the Management of Children and Adolescents with Bronchiectasis. European Respiratory Journal, 58, Article ID: 2002990. [Google Scholar] [CrossRef] [PubMed]
[28] Chang, A.B., Boyd, J., Bush, A., Grimwood, K., Hill, A.T., Powell, Z., et al. (2021) Children’s Bronchiectasis Education Advocacy and Research Network (Child-Bear-Net): An ERS Clinical Research Collaboration on Improving Outcomes of Children and Adolescents with Bronchiectasis. European Respiratory Journal, 58, Article ID: 2101657. [Google Scholar] [CrossRef] [PubMed]
[29] Pieters, A., Bakker, M., Hoek, R.A.S., Altenburg, J., van Westreenen, M., Aerts, J.G.J.V., et al. (2019) The Clinical Impact of Pseudomonas aeruginosa Eradication in Bronchiectasis in a Dutch Referral Centre. European Respiratory Journal, 53, Article ID: 1802081. [Google Scholar] [CrossRef] [PubMed]
[30] Dicker, A.J., Lonergan, M., Keir, H.R., Smith, A.H., Pollock, J., Finch, S., et al. (2021) The Sputum Microbiome and Clinical Outcomes in Patients with Bronchiectasis: A Prospective Observational Study. The Lancet Respiratory Medicine, 9, 885-896. [Google Scholar] [CrossRef] [PubMed]
[31] Chotirmall, S.H., Dhar, R., McShane, P.J. and Chang, A.B. (2023) Bronchiectasis: A Global Disease Necessitating Global Solutions. The Lancet Respiratory Medicine, 11, 581-583. [Google Scholar] [CrossRef] [PubMed]
[32] Chotirmall, S.H. and Chalmers, J.D. (2024) The Precision Medicine Era of Bronchiectasis. American Journal of Respiratory and Critical Care Medicine, 210, 24-34. [Google Scholar] [CrossRef] [PubMed]
[33] Park, Y.E., Sung, H. and Oh, Y. (2021) Respiratory Viruses in Acute Exacerbations of Bronchiectasis. Journal of Korean Medical Science, 36, e217. [Google Scholar] [CrossRef] [PubMed]
[34] Gao, Y., Guan, W., Xu, G., Tang, Y., Gao, Y., Lin, Z., et al. (2014) Macrolide Therapy in Adults and Children with Non-Cystic Fibrosis Bronchiectasis: A Systematic Review and Meta-Analysis. PLOS ONE, 9, e90047. [Google Scholar] [CrossRef] [PubMed]
[35] Marsh, R.L., Binks, M.J., Smith-Vaughan, H.C., Janka, M., Clark, S., Richmond, P., et al. (2022) Prevalence and Subtyping of Biofilms Present in Bronchoalveolar Lavage from Children with Protracted Bacterial Bronchitis or Non-Cystic Fibrosis Bronchiectasis: A Cross-Sectional Study. The Lancet Microbe, 3, e215-e223. [Google Scholar] [CrossRef] [PubMed]
[36] Rogers, G.B., Bruce, K.D., Martin, M.L., Burr, L.D. and Serisier, D.J. (2014) The Effect of Long-Term Macrolide Treatment on Respiratory Microbiota Composition in Non-Cystic Fibrosis Bronchiectasis: An Analysis from the Randomised, Double-Blind, Placebo-Controlled BLESS Trial. The Lancet Respiratory Medicine, 2, 988-996. [Google Scholar] [CrossRef] [PubMed]
[37] Chalmers, J.D., McHugh, B.J., Doherty, C., Smith, M.P., Govan, J.R., Kilpatrick, D.C., et al. (2013) Mannose-Binding Lectin Deficiency and Disease Severity in Non-Cystic Fibrosis Bronchiectasis: A Prospective Study. The Lancet Respiratory Medicine, 1, 224-232. [Google Scholar] [CrossRef] [PubMed]
[38] Hodge, S., Hodge, G., Jersmann, H., Matthews, G., Ahern, J., Holmes, M., et al. (2008) Azithromycin Improves Macrophage Phagocytic Function and Expression of Mannose Receptor in Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, 178, 139-148. [Google Scholar] [CrossRef] [PubMed]
[39] Sun, J. and Li, Y. (2021) Long-Term, Low-Dose Macrolide Antibiotic Treatment in Pediatric Chronic Airway Diseases. Pediatric Research, 91, 1036-1042. [Google Scholar] [CrossRef] [PubMed]
[40] Vicendese, D., Yerkovich, S., Grimwood, K., Valery, P.C., Byrnes, C.A., Morris, P.S., et al. (2023) Long-Term Azithromycin in Children with Bronchiectasis Unrelated to Cystic Fibrosis: Treatment Effects over Time. Chest, 163, 52-63. [Google Scholar] [CrossRef] [PubMed]
[41] Spencer, S., Donovan, T., Chalmers, J.D., Mathioudakis, A.G., McDonnell, M.J., Tsang, A., et al. (2022) Intermittent Prophylactic Antibiotics for Bronchiectasis. Cochrane Database of Systematic Reviews, 2022, CD013254. [Google Scholar] [CrossRef] [PubMed]
[42] O’Donnell, A.E. (2022) Bronchiectasis—A Clinical Review. New England Journal of Medicine, 387, 533-545. [Google Scholar] [CrossRef] [PubMed]
[43] Barış, S., Ercan, H., Cagan, H., et al. (2011) Efficacy of Intravenous Immunoglobulin Treatment in Children with Common Variable Immunodeficiency. Journal of Investigational Allergology & Clinical Immunology, 21, 514-521.
[44] Vivarelli, E., Matucci, A., Bormioli, S., Parronchi, P., Liotta, F., Cosmi, L., et al. (2021) Effectiveness of Low-Dose Intravenous Immunoglobulin Therapy in Minor Primary Antibody Deficiencies: A 2-Year Real-Life Experience. Clinical and Experimental Immunology, 205, 346-353. [Google Scholar] [CrossRef] [PubMed]
[45] 毛华伟. 原发性免疫缺陷病免疫球蛋白G替代治疗专家共识[J]. 中华儿科杂志, 2019, 57(12): 909-912.
[46] Zissler, U.M., Thron, A., Eckrich, J., Bakhtiar, S., Schubert, R. and Zielen, S. (2022) Bronchial Inflammation Biomarker Patterns Link Humoral Immunodeficiency with Bronchiectasis‐Related Small Airway Dysfunction. Clinical & Experimental Allergy, 52, 760-773. [Google Scholar] [CrossRef] [PubMed]
[47] Lee, A.L., Gordon, C.S. and Osadnik, C.R. (2018) Exercise Training for Bronchiectasis. Cochrane Database of Systematic Reviews, 4, CD013110. [Google Scholar] [CrossRef
[48] Jones, T., O’Grady, K.F., Goyal, V., Masters, I.B., McCallum, G., Drovandi, C., et al. (2022) Bronchiectasis-Exercise as Therapy (BREATH): Rationale and Study Protocol for a Multi-Center Randomized Controlled Trial. Trials, 23, Article No. 292. [Google Scholar] [CrossRef] [PubMed]