支气管热成形术在哮喘中作用的新认识
2017/10/23
摘要
支气管热成形术是一种应用于最佳内科治疗方案无效的中重度哮喘患者的内镜治疗手段。支气管热成形术的疗效已在多项随机临床试验中得到描述。然而，何种表型的哮喘收益最大并不清楚，部分原因是其作用机制尚不完全清楚。支气管热成形术原本的目的是为了减少气道平滑肌的数量，但是可以想象它对气道的病理生理也会产生直接或间接的影响。本综述对不同气道病理生理过程进行了概览，包括气道重塑（气道平滑肌细胞为关键因素）。当前对支气管热成形术临床效果中气道重塑的概念在文中将被综述。
Emerging understanding of the mechanism of action of Bronchial Thermoplasty in asthma
d'Hooghe JNS, Ten Hacken NHT, Weersink EJM, Sterk PJ, Annema JT, Bonta PI.
Abstract
INTRODUCTION:Bronchial Thermoplasty (BT) is an endoscopic treatment for moderate-to-severe asthma patients who are uncontrolled despite optimal medical therapy. Effectiveness of BT has been demonstrated in several randomized clinical trials. However, the asthma phenotype that benefits most of this treatment is unclear, partly because the mechanism of action is incompletely understood. BT was designed to reduce the amount of airway smooth muscle (ASM), but additional direct and indirect effects on airway pathophysiology are expected. This review will provide an overview of the different components of airway pathophysiology including remodeling, with the ASM as the key player. Current concepts in the understanding of BT clinical effectiveness with a focus on its impact on airway remodeling will be reviewed.
支气管热成形术是一种应用于最佳内科治疗方案无效的中重度哮喘患者的内镜治疗手段。支气管热成形术的疗效已在多项随机临床试验中得到描述。然而，何种表型的哮喘收益最大并不清楚，部分原因是其作用机制尚不完全清楚。支气管热成形术原本的目的是为了减少气道平滑肌的数量，但是可以想象它对气道的病理生理也会产生直接或间接的影响。本综述对不同气道病理生理过程进行了概览，包括气道重塑（气道平滑肌细胞为关键因素）。当前对支气管热成形术临床效果中气道重塑的概念在文中将被综述。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Pharmacol Ther. 2017 Jul 27. pii: S0163-7258(17)30195-X. doi: 10.1016/j.pharmthera.2017.07.015. [Epub ahead of print])
(Pharmacol Ther. 2017 Jul 27. pii: S0163-7258(17)30195-X. doi: 10.1016/j.pharmthera.2017.07.015. [Epub ahead of print])
Emerging understanding of the mechanism of action of Bronchial Thermoplasty in asthma
d'Hooghe JNS, Ten Hacken NHT, Weersink EJM, Sterk PJ, Annema JT, Bonta PI.
Abstract
INTRODUCTION:Bronchial Thermoplasty (BT) is an endoscopic treatment for moderate-to-severe asthma patients who are uncontrolled despite optimal medical therapy. Effectiveness of BT has been demonstrated in several randomized clinical trials. However, the asthma phenotype that benefits most of this treatment is unclear, partly because the mechanism of action is incompletely understood. BT was designed to reduce the amount of airway smooth muscle (ASM), but additional direct and indirect effects on airway pathophysiology are expected. This review will provide an overview of the different components of airway pathophysiology including remodeling, with the ASM as the key player. Current concepts in the understanding of BT clinical effectiveness with a focus on its impact on airway remodeling will be reviewed.
