哮喘联盟

   摘要
   目的：研究活性氮（RNS）在哮喘发病机理中的分子机制，并评价呼出气一氧化氮（FENO）检测与哮喘标准临床评估联合使用的情况。
   数据来源：通过搜索Pubmed、Google Scholar和Medline数据库，一项广泛的医学文献综述对哮喘病理和处理进行了以下领域的探讨：过敏性哮喘、RNS，一氧化氮（NO），气道炎症和FENO。
   研究选择：研究的选择基于RNS在过敏性哮喘的生理作用和病理生理作用。当前对FENO在治疗哮喘中的临床应用评估也被纳入研究。
   结果：在哮喘开始发作时，NO的大量生成与诱导型NO合酶（NOS）活性增加有关，而内皮NOS和神经元NOS主要调节中枢和外周气道的正常代谢功能。在过敏性炎症反应中，NO和超氧化物形成过氧硝酸盐，后者对呼吸道功能有损害作用。RNS通过亚硝化应激加重气道炎症和细胞毒性。另外，FENO监测嗜酸性细胞介导的气道炎症是一个潜在的有效评估方法，可补充哮喘进展的标准监测流程。
   结论：本综述研究了有关NO和NO衍生RNS在哮喘病理中的分子机制的最新证据，并且认为FENO监测可能显著有助于哮喘诊断。

 

（刘国梁 审校）
Ann Allergy Asthma Immunol. 2014 Jan;112(1):18-22. doi: 10.1016/j.anai.2013.10.007. Epub 2013 Nov 6.

 

Characterization of reactive nitrogen species in allergic asthma.
 

Zuo L1, Koozechian MS2, Chen LL3.
 

Abstract
OBJECTIVE: To investigate the molecular mechanism of reactive nitrogen species (RNS) in the pathogenesis of asthma and examine the use of fractional exhaled nitric oxide (FENO) measurements in close conjunction with standard clinical assessments of asthma.
DATA SOURCES: Through PubMed, Google Scholar, and Medline databases, a broad medical literature review was performed in the following areas of asthma pathobiology and management: allergic asthma, RNS, nitric oxide (NO), airway inflammation, and FENO.
STUDY SELECTIONS: Studies were selected based on the physiologic and pathophysiologic roles of RNS in relation to allergic asthma. Current evaluations on clinical applications of FENO in asthma treatment also were selected.
RESULTS: At the onset of an asthma attack, an enhanced production of NO strongly correlates with increase inducible NO synthase (NOS) activity, whereas endothelial NOS and neuronal NOS regulate primarily normal metabolic functions in the central and peripheral airways. During allergic inflammatory responses, NO and superoxide form peroxynitrite, which has deleterious effects in the respiratory tract. RNS directly accentuates airway inflammation and cytotoxicity through nitrosative stress. Moreover, the use of FENO to monitor eosinophilic-mediated airway inflammation is a potentially valuable assessment that supplements standard procedures to monitor the progression of asthma.
CONCLUSION: This review examines recent evidence implicating the molecular mechanisms of NO and NO-derived RNS in the pathobiology of asthma and suggests that monitoring FENO may markedly contribute to asthma diagnosis.
 

Ann Allergy Asthma Immunol. 2014 Jan;112(1):18-22. doi: 10.1016/j.anai.2013.10.007. Epub 2013 Nov 6.