Asthma: the importance of epithelial mesenchymal communication in pathogenesis - Inflammation and the airway epithelium in asthma
Asthma: the importance of epithelial mesenchymal communication in pathogenesis - Inflammation and the airway epithelium in asthma
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DOI：
10.1016/s1357-2725(02)00048-1
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发表时间：
2002-12-01
影响因子：
4
通讯作者：
Holgate, ST
中科院分区：
文献类型：
--
作者：
Davies, DE;Holgate, ST
哮喘是一种气道疾病，其中 Th-2 介导的炎症被认为是结构和功能改变的基础，从而导致支气管高反应性 (BHR) 和可变气流阻塞。基于对儿童早期疾病病理学的观察、影响特应性和 BHR 的独立遗传因素、尽管具有强大的抗炎作用但对皮质类固醇治疗的不完全反应，以及最近几乎消除血液和气道中的嗜酸粒细胞增多但对哮喘临床结果几乎没有影响的靶向治疗的令人失望的结果，这种支撑哮喘病理生理学的线性进展受到质疑。提出了另一种假设，其中特应性/气道炎症和形成的气道元件的结构和功能改变是平行但相互作用的因素。哮喘要发展成为一种慢性疾病，需要驱动这些成分的遗传和环境因素。其基础是气道上皮和底层间质之间的异常信号传递以及上皮间质营养单位的持续激活的概念。 (C) 2002 Elsevier Science Ltd. 保留所有权利。
Asthma is a disorder of the airways in which Th-2-mediated inflammation is considered to provide the basis for altered structure and function that leads to bronchial hyper-responsiveness (BHR) and variable airflow obstruction. This linear progression underpinning asthma pathophysiology is questioned on the basis of observations on the pathology of the disease in early childhood, the independent genetic factors that influence atopy and BHR, incomplete responses to treatment with corticosteroids despite powerful anti-inflammatory effects and the recent disappointing results with targeted therapies that almost abolish eosinophilia in the blood and airways and yet produce little effect on the clinical outcomes of asthma. An alternative hypothesis is put forward in which atopy/airway inflammation and altered structure and function of the formed airway elements are parallel but interacting factors. For asthma to develop as a chronic disease, genetic and environmental factors that drive each of these components are required. Fundamental to this is the concept of aberrant signalling between the airway epithelium and underlying mesenchyme and persistent activation of the epithelial mesenchymal trophic unit. (C) 2002 Elsevier Science Ltd. All rights reserved.