哮喘联盟

   摘要
   气道重塑由反复损害和修复的过程促使气道壁的结构改变形成。组织，细胞和分子组成的改变，影响气道平滑肌，上皮，血管和细胞外基质为特征。它发生在有慢性炎症气道疾病的患者身上如哮喘，COPD，支气管扩张和囊性纤维化。气道重塑在这些疾病中可以被认为是最棘手的问题，导致肺功能不可逆的丧失。目前治疗方法可以改善炎症，但是没有一个可行的治疗被证明可以阻止或逆转气道重塑，尽管逆转气道重塑在疾病动物模型的研究中被促成。气道重塑也常常被认为是气道炎症长期存在的结果，但是它可能同等程度的表现在哮喘儿童的气道中，这增长了早期的和具体的药物干预的需要。在这个综述中，我们考虑对促成气道重塑的因素和讨论目前的与潜在的治疗干预。

 

（苏新明 中国医科大学附属一院呼吸科 110001 摘译）
（Hirota N, Martin JG. Chest. 2013 Sep;144(3):1026-32）

 

Mechanisms of airway remodeling.
 

Hirota N, Martin JG. Chest.2013Sep;144(3):1026-32. doi: 10.1378/chest.12-3073.
 

Abstract
Airway remodeling comprises the structural changes of airway walls, induced by repeated injury and repair processes. It is characterized by the changes of tissue, cellular, and molecular composition, affecting airway smooth muscle, epithelium, blood vessels, and extracellular matrix. It occurs in patients with chronic inflammatory airway diseases such as asthma, COPD, bronchiectasis, and cystic fibrosis. Airway remodeling is arguably one of the most intractable problems in these diseases, leading to irreversible loss of lung function. Current therapeutics can ameliorate inflammation, but there is no available therapy proven to prevent or reverse airway remodeling, although reversibility of airway remodeling is suggested by studies in animal models of disease. Airway remodeling is often considered the result of longstanding airway inflammation, but it may be present to an equivalent degree in the airways of children with asthma, raising the necessity for early and specific therapeutic interventions. In this review, we consider the factors that may contribute to airway remodeling and discuss the current and potential therapeutic interventions.

Hirota N, Martin JG. Chest. 2013 Sep;144(3):1026-32