Mechanisms of Airway Remodeling
Mechanisms of Airway Remodeling
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DOI：
10.1378/chest.12-3073
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发表时间：
2013-09-01
期刊：
影响因子：
9.6
通讯作者：
Martin, James G.
中科院分区：
文献类型：
--
作者：
Hirota, Nobuaki;Martin, James G.
气道重塑包括气道壁的结构改变，由反复损伤和修复过程引起。其特征是组织、细胞和分子组成的改变，影响气道平滑肌、上皮、血管和细胞外基质。常见于慢性炎症性气道疾病，如哮喘、COPD、支气管扩张症和囊性纤维化。气道重塑可以说是这些疾病中最棘手的问题之一，导致不可逆转的肺功能丧失。目前的治疗方法可以改善炎症，但没有可用的治疗方法被证明可以预防或逆转气道重塑，尽管在疾病的动物模型中研究表明气道重塑的可逆性。气道重塑通常被认为是长期气道炎症的结果，但它可能在哮喘儿童的气道中以同等程度存在，这提高了早期和特异性治疗干预的必要性。在这篇综述中，我们考虑了可能导致气道重塑的因素，并讨论了当前和潜在的治疗干预措施。
Airway remodeling comprises the structural changes of airway walls, induced by repeated injury and repair processes. It is characterized by the changes of tissue, cellular, and molecular composition, affecting airway smooth muscle, epithelium, blood vessels, and extracellular matrix. It occurs in patients with chronic inflammatory airway diseases such as asthma, COPD, bronchiectasis, and cystic fibrosis. Airway remodeling is arguably one of the most intractable problems in these diseases, leading to irreversible loss of lung function. Current therapeutics can ameliorate inflammation, but there is no available therapy proven to prevent or reverse airway remodeling, although reversibility of airway remodeling is suggested by studies in animal models of disease. Airway remodeling is often considered the result of longstanding airway inflammation, but it may be present to an equivalent degree in the airways of children with asthma, raising the necessity for early and specific therapeutic interventions. In this review, we consider the factors that may contribute to airway remodeling and discuss the current and potential therapeutic interventions.