哮喘联盟

   摘要
   哮喘是一种伴有功能和结构改变的呼吸道炎症性疾病，进而导致支气管高反应性（BHR）和气流阻塞。气道结构改变或重塑包括：上皮损伤、杯状细胞增生、上皮下层增厚、气道平滑肌增生以及血管再生。这些改变先前被认为是慢性气道炎症的结果。然而，多项研究表明气道炎症和气道重塑可看作是哮喘发病过程中两个独立且平行的因素。同样地，越来越多的证据表明，哮喘患者气道中的机械压缩力导致了气道的结构性变化。另外，改善气道重塑的最佳疗法和干预靶点目前仍不清楚。甄别哮喘表型也是有必要的，因其对于诸如anti-IL5、anti-IL13和酪氨酸激酶抑制剂等新疗法可能会有特异性反应。
 

（苏楠 审校）
Asian Pac J Allergy Immunol. 2013 Mar;31(1):3-10.
 

Airway remodelling in asthma and novel therapy.

Manuyakorn W, Howarth PH, Holgate ST.

Source
Division of Pediatric Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, THAILAND.

Abstract
Asthma is an airway inflammatory disease with functional and structural changes, leading to bronchial hyperresponsiveness (BHR) and airflow obstruction. Airway structural changes or airway remodelling consist of epithelial injury, goblet cell hyperplasia, subepithelial layer thickening, airway smooth muscle hyperplasia and angiogenesis. These changes were previously considered as a consequence of chronic airway inflammation. However, several studies have demonstrated that inflammation and remodelling can occur as separate but parallel aspects of the asthmatic process. As such there is increasing evidence for the role of mechano compressive forces within the asthmatic airway contributing to airway structural changes. Furthermore, it is unclear what is the best treatment to modify remodelling and which component to target. There is also a need to identify asthma phenotype that might specifically respond to novel therapies such as anti-IL5, anti-IL13 and tyrosine kinase inhibitors.
 

Asian Pac J Allergy Immunol. 2013 Mar;31(1):3-10.