Mechanisms and markers of airway inflammation in cystic fibrosis
Mechanisms and markers of airway inflammation in cystic fibrosis
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DOI：
10.1183/09031936.02.00229202
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发表时间：
2002-02-01
影响因子：
24.3
通讯作者：
De Rse, V
中科院分区：
文献类型：
--
作者：
De Rse, V
气道炎症现在被认为是囊性纤维化（CF）肺部疾病发病机制的一个主要因素。其最显著的特征是中性粒细胞显著且持续地涌入气道，中性粒细胞通过释放有害介质（如活性氧和蛋白水解酶）损害肺部。最近的研究表明，炎症很早就发生，甚至可能在没有感染的情况下发生。此外，假设CF跨膜电导调节功能障碍与感染和炎症之间存在联系；细胞因子产生的失调和上皮宿主防御的异常被认为是持续炎症的原因。支气管肺泡灌洗和中性粒细胞和炎症介质的评估提供了气道炎症的最准确的图像。然而，常规支气管镜检查伴支气管肺泡灌洗对患者来说是不愉快的，通常对个别病例的治疗没有立竿见影的效果。因此，通过非侵入性方法收集的替代标志物将对囊性纤维化患者的随访有很大的帮助。囊性纤维化患者的痰、血清和尿液中有几种与气道炎症程度相关的标志物。需要长期研究来证实它们潜在的临床效用和特异性，并确定哪些可以在临床上用于监测疾病结局和治疗效果。
Airway inflammation is now recognized as a major factor in the pathogenesis of lung disease in cystic fibrosis (CF). Its most characteristic feature is a marked and persistent influx into the airways of neutrophils, which damage the lung by releasing noxious mediators, such as reactive oxygen species and proteolytic enzymes.Recent studies suggest that inflammation occurs very early and may even happen in the absence of infection. Furthermore, links between CF transmembrane conductance regulator dysfunction and both infection and inflammation are postulated; dysregulation of cytokine production and abnormal epithelial host defences have been regarded as causes of sustained inflammation.Bronchoalveolar lavage and the evaluation of neutrophils and inflammatory mediators provide the most accurate picture of airway inflammation. Routine bronchoscopy with bronchoalveolar lavage, however, is unpleasant for the patient and usually is of no immediate benefit to the management of individual cases.Therefore, surrogate markers collected by noninvasive procedures would be of great assistance in the follow-up of cystic fibrosis patients. Several markers have been evaluated in the sputum, serum and urine of cystic fibrosis patients and related to the degree of airway inflammation. Long-term studies are needed to confirm their potential clinical utility and specificity, and to determine which can be used clinically to monitor disease outcome and efficacy of treatment.