Pathophysiology of asthma
Pathophysiology of asthma
复制标题
DOI：
10.1046/j.1365-2125.1996.03721.x
复制
发表时间：
1996-07-01
影响因子：
3.4
通讯作者：
Barnes, PJ
中科院分区：
文献类型：
--
作者：
Barnes, PJ
在过去的几年里，我们对哮喘及其治疗的理解发生了显著的变化，特别是随着分子和细胞生物学的应用以及新的、更特异的药理学工具的发现许多炎症细胞参与哮喘的炎症过程并介导复杂的介质混合物，细胞因子作为慢性炎症的介质特别重要，并且细胞因子放大和延续炎症过程的手段正在出现。气道上皮细胞可能是细胞因子和其他介质（如一氧化氮和内皮素）的一个特别重要的来源，并且可能是吸入类固醇的主要靶细胞，这是目前最有效的哮喘治疗方法哮喘的炎症过程不仅导致支气管收缩，还导致血浆渗出、神经机制激活、粘液分泌。慢性炎症可导致结构改变，包括气道平滑肌和纤维化的增加，这本质上是不可逆的。越来越多的证据表明转录因子，如NF-kappa B，在哮喘炎症基因的表达中起关键作用，可能是糖皮质激素的主要分子靶点。
1 Our understanding of asthma and its therapy has changed markedly over the last few years, particularly with the application of molecular and cell biology and the discovery of new and more specific pharmacological tools.2 Many inflammatory cells participate in the inflammatory process in asthma and mediate a complex mixture of mediators, Cytokines are of particular importance as mediators of chronic inflammation and the means by which cytokines amplify and perpetuate the inflammatory process is now emerging. Airway epithelial cells may be a particularly important source of cytokines and other mediators, such as nitric oxide and endothelin, and may be a major target cell for inhaled steroids, which are the most effective therapy for asthma currently available.3 The inflammatory process in asthma results not only in bronchoconstriction, but also plasma exudation, the activation of neural mechanisms, mucus secretion. The chronic inflammation may lead to structural changes, including an increase in airway smooth muscle and fibrosis, that are essentially irreversible, There is increasing evidence that transcription factors, such as NF-kappa B, play a pivotal role in the expression of inflammatory genes in asthma and may be the major molecular target for glucocorticoids.