气道疾病中的咳嗽与病毒
2009/08/11
急性咳嗽是病毒性呼吸道感染的主要症状，而且在全球范围内都具有较高的人群发病率。多种病毒在急性感染后都会导致咳嗽症状的出现，而且不同年龄人群的临床症状基本类似。虽然急性咳嗽给社会带来了沉重的负担，但是对于病毒感染后出现急性咳嗽的机制却知之甚少。
体内、体外研究均显示，病毒感染后出现的神经肽和白三烯生成增加介导了咳嗽，并伴随有神经受体的改变。气道粘液产生增加也可能发挥了重要作用。本文主要综述了目前关于病毒感染后急性咳嗽的相关发生机制研究。
随着鼻病毒感染小鼠模型，以及哮喘或慢性阻塞性肺疾病（COPD）患者鼻病毒刺激试验模型的建立，目前正将研究领域从体外试验向临床试验扩展，最终有希望能应用于临床实践。对病毒诱导性咳嗽的具体发生机制进行深入了解有助于制定出更具特异性、更有效的治疗措施。
（陈欣 审校）
Footitt J, et al. Pulm Pharmacol Ther. 2009 Apr;22(2):108-113.
Cough and viruses in airways disease: mechanisms.
Footitt J, Johnston SL.
Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College London, Norfolk Place, London, UK.
Acute cough is a major symptom of viral respiratory tract infection and causes excessive morbidity in human populations across the world. A wide variety of viruses play a role in the development of cough after acute infection and all of these manifest a similar clinical picture across different age groups. Despite the large disease burden surprisingly little is known about the mechanism of acute cough following viral infection. Both in vitro and in vivo experiments show that increased production of neuropeptides and leukotrienes mediate cough after viral infection, along with altered expression of neural receptors. Increased airway mucus production is also likely to play a significant role. This work is reviewed in this article. Following the recent development of a mouse model for rhinovirus infection and the establishment of experimental models of rhinovirus challenge in human subjects with both asthma and COPD the field is expanding to translate in vitro research into clinical studies and hopefully eventually into clinical practice. Developing a clearer understanding of the mechanisms underlying virus induced cough may lead to more specific and effective therapies.
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同时刺激喉及气管支气管受体或刺激中枢呼吸神经元能增加咳嗽反射强度
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鼻后滴漏与慢性咳嗽：一项开放式干预研究
