哮喘联盟

   摘要
   目的：利用上、下呼吸道数据研究哮喘发病机制。
   数据来源：发表于1990年后有关哮喘和鼻息肉的英文文献。
   资料选择：已成立期刊中的高质量研究
   结果：炎症本质的确认引起对哮喘认识和治疗的快速发展例如吸入糖皮质激素提高患者生存。对基因、分子、组织学和临床的进一步研究表明，哮喘是多态性的、很少涉及单独Th2的支气管炎症。病毒感染可能在儿童和成人中扮演起始事件的角色，与特异反应性有协同的作用。慢性葡萄球菌定植于粘膜可能是一个始动因子，如同过敏性皮炎一样。这两种结果可能存在关联：病毒为细菌提供一个进入粘膜上皮细胞的门户。
   结论：绝大多数哮喘始于鼻部，涉及过敏反应和感染：病毒和细菌。综合考虑特应质和感染可提示新的治疗的可能。
 

（林江涛 审校）
Clin Respir J. 2014 Mar 10. doi: 10.1111/crj.12128. [Epub ahead of print]

 

Allergens, germs and asthma.
 

Scadding GK.
 

ABSTRACT
OBJECTIVE: To explore asthma pathogenesis using data from upper and lower airways DATA SOURCE: English language papers on human asthma and nasal polyp subjects from 1990 onwards .
STUDY SELECTION: High quality studies in established journals.
RESULTS: The recognition of its inflammatory nature led to a quantum leap in the understanding and treatment of asthma, with lives saved by inhaled corticosteroids. Further work at genetic, molecular, histological and clinical levels has shown that asthma is polymorphic and rarely involves isolated Th2 bronchial inflammation. Viral infections may act as an initiating event in children and adults, showing synergy with atopy. Chronic Staphylococcal colonization of the mucosa may act as a promoter, as in atopic dermatitis. These two observations may be linked: with viruses providing an entry for bacteria into the mucosal epithelium .
CONCLUSIONS: Most asthma begins in the nose and involves allergy and infection: both viral and bacterial.The combination of atopy and infection suggests new possibilities for therapy.
 

Clin Respir J. 2014 Mar 10. doi: 10.1111/crj.12128. [Epub ahead of print]