Platelets in patients with aspirin-exacerbated respiratory disease.
Platelets in patients with aspirin-exacerbated respiratory disease.
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DOI：
10.1016/j.jaci.2015.02.005
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发表时间：
2015-06
期刊：
影响因子：
--
通讯作者：
Boyce JA
中科院分区：
文献类型：
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作者：
Laidlaw TM;Boyce JA
阿司匹林急性呼吸道疾病（AERD）是一种慢性炎症性疾病，其临床特征为哮喘、鼻息肉病和吸入阿司匹林后的特异性呼吸道反应三联征。这是一种与呼吸道组织嗜酸性粒细胞浸润和半胱氨酰白三烯过度产生相关的独特综合征。尽管呼吸道疾病的临床表型一致，但疾病的潜在发病机制仍不清楚。除了它们在止血中的作用之外，血小板具有在炎症期间影响其他免疫细胞的活化状态和功能的能力，并且促进粒细胞募集到组织中。血小板还具有在激活时释放的有效的预先形成的炎症介质的库，并且是改变血管通透性和平滑肌张力的新合成的脂质介质的丰富来源。因此，血小板的活性与包括哮喘在内的各种炎症性疾病有关。人类和动物研究均强烈表明，血小板活性与AERD的病理生理学唯一相关。本文总结了支持血小板在哮喘和AERD中的效应作用的证据，并考虑了潜在的治疗意义。
Aspirin-exacerbated respiratory disease (AERD) is a chronic inflammatory disease characterized clinically by the triad of asthma, nasal polyposis, and pathognomonic respiratory reactions after ingestion of aspirin. It is a distinct syndrome associated with eosinophilic infiltration of respiratory tissues and excessive production of cysteinyl leukotrienes. Despite the consistent clinical phenotype of the respiratory disease, the underlying pathogenesis of the disease remains unclear. In addition to their role in hemostasis, platelets have the capacity to influence the activation state and function of other immune cells during inflammation, and to facilitate granulocyte recruitment into the tissues. Platelets also possess a repertoire of potent pre-formed mediators of inflammation that are released upon activation, and are a rich source of newly-synthesized lipid mediators that alter vascular permeability and smooth muscle tone. Accordingly, the activity of platelets has been linked to diverse inflammatory diseases, including asthma. Both human and animal studies strongly suggest that platelet activity is uniquely associated with the pathophysiology of AERD. This article summarizes the evidence supporting an effector role for platelets in asthma in general and in AERD in particular, and considers the potential therapeutic implications.