Airway hydration and COPD.
Airway hydration and COPD.
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DOI：
10.1007/s00018-015-1946-7
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发表时间：
2015-10
期刊：
影响因子：
--
通讯作者：
Tarran R
中科院分区：
文献类型：
--
作者：
Ghosh A;Boucher RC;Tarran R
慢性阻塞性肺疾病（COPD）是世界范围内死亡的主要原因之一，包括两种主要的临床表型，即，慢性支气管炎（CB）和肺气肿。慢性阻塞性肺病最常见的原因是慢性烟草吸入。针对COPD的慢性支气管炎表型的研究已经确定了驱动疾病开始和进展的几个病理过程。例如，肺的粘膜纤毛清除（MCC）系统执行从肺清除吸入的病原体和有毒物质的关键任务。MCC效率取决于：（i）顶端质膜离子通道如囊性纤维化跨膜传导调节因子（CFTR）和上皮Na+通道（ENaC）维持气道水合的能力;（ii）纤毛搏动;和（iii）适当的粘蛋白分泌速率。这些组分中的每一种在CB中受损，并可能导致CB患者中观察到的粘液淤滞/积聚。这篇综述强调了负责维持MCC的细胞成分，以及烟草暴露和CB如何破坏这一过程。我们还将讨论现有的治疗慢性支气管炎的治疗策略，以及如何将MCC的组分用作评估烟草或烟草样产品暴露的生物标志物。
Chronic obstructive pulmonary disease (COPD) is one of the prevalent causes of worldwide mortality and encompasses two major clinical phenotypes, i.e., chronic bronchitis (CB) and emphysema. The most common cause of COPD is chronic tobacco inhalation. Research focused on the chronic bronchitic phenotype of COPD has identified several pathological processes that drive disease initiation and progression. For example, the lung’s mucociliary clearance (MCC) system performs the critical task of clearing inhaled pathogens and toxic materials from the lung. MCC efficiency is dependent on: (i) the ability of apical plasma membrane ion channels such as the cystic fibrosis transmembrane conductance regulator (CFTR) and the epithelial Na+ channel (ENaC) to maintain airway hydration; (ii) ciliary beating; and, (iii) appropriate rates of mucin secretion. Each of these components is impaired in CB and likely contributes to the mucus stasis/accumulation seen in CB patients. This review highlights the cellular components responsible for maintaining MCC and how this process is disrupted following tobacco exposure and with CB. We shall also discuss existing therapeutic strategies for the treatment of chronic bronchitis and how components of the MCC can be used as biomarkers for the evaluation of tobacco or tobacco-like-product exposure.