Abstract
Background: Recent metabolomics studies have found circulatory metabolism alterations in patients with asthma, indicating that altered metabolites played a significant role in asthma. However, the regulatory mechanisms in asthma, especially in young chronic persistent asthma remain underexplored. Methods: In this study, a prospective cohort of 162 patients diagnosed of asthma admitted to the First Affiliated Hospital of Xi’an Jiaotong University from January 2018 to December 2019 was used to perform a nested case-control study. Among them, we included 30 patients with chronic persistent asthma between 20 to 35 years old; 30 health control with evenly distributed age and sex were then recruited. Nontargeted metabolomics was applied to identify serum metabolic profiles and altered metabolic pathways. Results: In vitro, human bronchial epithelial cells (HBECs) line BEAS-2B with the addition of L-citrulline and/or asymmetric dimethylarginine (ADMA) model was utilized and the concentrations of nitric oxide (NO) metabolites were tested to evaluate the therapeutic potential of L-citrulline. The young patients with chronic persistent asthma displayed dysregulated serum metabolic profiles, especially enriched in arginine metabolism. The ratio of L-citrulline to ornithine is associated with blood eosinophil count. In vitro, adding L-citrulline could reverse ADMA-mediated reduction of NOx at lower L-arginine concentration (25 μM), but was ineffective in the higher L-arginine concentration (100 μM) media. Conclusions: The arginine metabolism balance is of vital importance during the pathogenesis and progression of chronic asthma. L-citrulline could be a powerful approach to restore airway NO production, potentially exhibiting therapeutic benefits among young patients with chronic asthma.
Highlights
Bronchial asthma, as a kind of chronic inflammatory diseases, is characterized by reversible airway hyperresponsiveness (AHR) and chronic airway remodeling
No significant difference in age, gender and body mass index (BMI) were seen between chronic persistent asthma patients and healthy control
The ratio of to ornithine is significantly negatively associated with blood eosinophil count
Summary
As a kind of chronic inflammatory diseases, is characterized by reversible airway hyperresponsiveness (AHR) and chronic airway remodeling. Allergen inhalation results in inflammatory producing factors such as IL-4, IL-5, IL-13 and TNFα in. Th2 and mast cells [1]. Eosinophils are increased in blood and bronchoalveolar lavage fluid (BALF). The airway epithelium is thought to play an important role in the pathogenesis of asthma. Activated stress of airway epithelial cells may contribute to inflammation and airway remodeling in the development of asthma [2]. The regulatory mechanisms in asthma, especially in young chronic persistent asthma remain underexplored
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