血清GATA3、TSLP、LXA4水平与儿童变应性鼻炎Th1/Th2免疫失衡及病情严重程度的关系OA

Objective To investigate the associations of serum GATA-binding protein 3(GATA3),thymic stromal lymphopoietin(TSLP)and lipoxin A4(LXA4)levels with T-helper cells(Th)1/Th2 immune imbal-ance and disease severity in children with allergic rhinitis(AR),and to evaluate their ability to discriminate between mild and moderate-to-severe AR.Methods A total of 102 children with AR admitted to Huai'an Fifth People's Hospital between May 2022 and May 2025 were included in the observation group.According to the disease severity grading criteria specified in the relevant guidelines,they were divided into a mild group(32 cases)and a moderate-to-severe group(70 cases).An additional 99 age-and sex-matched healthy children who underwent physical examinations during the same period were included in the control group.Serum GATA3,TSLP,and LXA4 levels,the proportions of Th1 and Th2,and the Th1/Th2 ratio were compared between the observation and control groups and between the mild and moderate-to-severe groups.Pearson correlation anal-ysis was performed to assess the correlations of serum GATA3,TSLP,and LXA4 levels with the proportions of Th1 and Th2 and the Th1/Th2 ratio in children with AR.Multivariate Logistic regression analysis was per-formed to identify factors associated with moderate-to-severe AR.Receiver operating characteristic(ROC)curve was used to evaluate the individual and combined discriminatory performance of serum GATA3,TSLP,and LXA4 levels in distinguishing mild from moderate-to-severe AR.Results Serum GATA3,TSLP and LXA4 levels and the proportion of Th2 were significantly higher in the observation group than those in the control group(P<0.05),whereas the proportion of Th1 and the Th1/Th2 ratio were significantly lower(P<0.05).Serum GATA3,TSLP and LXA4 levels and the proportion of Th2 were significantly higher in the moderate-to-severe group than those in the mild group(P<0.05),whereas the proportion of Th1 and the Th1/Th2 ratio were significantly lower(P<0.05).Serum GATA3,TSLP and LXA4 levels were negatively correlated with the proportion of Th1 and the Th1/Th2 ratio and positively correlated with the proportion of Th2 in children with AR(P<0.05).Multivariate Logistic regression analysis showed that serum GATA3,TSLP,and LXA4 levels,the proportions of Th1 and Th2,and the Th1/Th2 ratio were all influencing factors for moderate-to-severe AR(P<0.05).ROC curve analysis showed that the areas under the curves of GA-TA3,TSLP,and LXA4 individually and in combination for discriminating between mild and moderate-to-se-vere AR were 0.715,0.689,0.738,and 0.928 respectively.Conclusion Serum GATA3,TSLP and LXA4 levels are abnormally elevated in children with AR and are associated with Th1/Th2 immune imbalance.GATA3,TSLP,LXA4,and Th1/Th2-related indices are closely associated with AR severity.The AUC of the three-marker combina-tion is greater than that of each individual marker,suggesting potential value for disease severity stratification.