Anti-inflammatory therapy in cystic fibrosis.
Anti-inflammatory therapy in cystic fibrosis.
复制标题
DOI：
10.1016/j.jcf.2005.05.010
复制
发表时间：
2005-08-01
期刊：
影响因子：
--
通讯作者：
Dinwiddie, Robert
中科院分区：
文献类型：
--
作者：
Dinwiddie, Robert
炎症在CF肺部疾病的病理生理学中发挥着重要作用。这种反应可能主要是由于受累肺无法抵抗这种疾病中最常见的细菌病原体（即金黄色葡萄球菌、流感嗜血杆菌和铜绿假单胞菌）的侵袭而引发的。关于CFTR的基本功能缺陷是否可能存在肺部炎症前期的争论仍在继续。迄今为止，最受测试的抗炎治疗方式是：口服皮质类固醇，有效但与显著的长期副作用相关，吸入皮质类固醇，迄今为止未被证明是有效的，可能是因为难以通过肺的粘性表面分泌物吸收，以及布洛芬，可能有效但受到侵入性监测药物水平和潜在胃肠道副作用的需要的抑制。最有希望的新药物是大环内酯类抗生素，如阿奇霉素，作为一种长期抗炎剂，具有良好的安全性。
Inflammation plays a major role in the pathophysiology of lung disease in CF. This response is probably triggered primarily as a reaction to the inability of the affected lung to resist the invasion of the most common bacterial pathogens seen in this disease, namely, Staphylococcus aureus, Haemophilus influenzae and Pseudomonas aeruginosa. Debate continues as to whether there may or may not be a pre-inflammation of the lungs as part of the basic functional defect of CFTR. The anti-inflammatory treatment modalities most tested to date are: oral corticosteroids, effective but associated with significant long-term side effects, inhaled corticosteroids, so far not proven to be effective probably because of difficulty with absorption through the viscid surface secretions of the lung and ibuprofen, potentially effective but inhibited by the need to monitor drug levels invasively and potential gastrointestinal side effects. The most promising newcomer is macrolide antibiotics such as azithromycin acting as a long-term anti-inflammatory agent with an excellent safety profile.