哮喘联盟

   摘要
   哮喘仍然是全球公共卫生问题之一，因此需要更有效的药物治疗，特别是对于慢性和重度哮喘患者。在这些临床表型中，涉及中性粒细胞的慢性炎症可能起着致病作用，因此，以涉及中性粒细胞聚集的细胞因子信号通路作为治疗靶点正成为时下的研究热点，原型辅助T细胞17分泌的细胞因子白介素(IL)-17A，也可能是IL-17F，便是其中之一，有不同的气道模型实验显示，其可控制中性粒细胞聚集、黏液分泌、巨噬细胞活化和平滑肌反应性。然而，关于在哮喘人群中IL-17细胞因子所介导的信号通路却了解甚少。目前的证据表明在哮喘中，有几种类型的免疫细胞可释放这些细胞因子，对于IL-7A而言，其局部水平的增加与疾病严重程度相关，同时伴有气道中性粒细胞和局部平滑肌细胞的活化。虽然IL-17细胞因子的致病作用仍不明确，但IL-17A特异性靶向治疗对中-重度哮喘且伴高度可逆性的患者具有潜在的临床效用。关于在这类临床表型中IL-17细胞因子介导的信号通路机制，仍需要进行新的和良好效能的临床研究加以探讨。
 

（林江涛 审校）
Eur Respir J. 2014 Jun 12. pii: erj00023-2014. [Epub ahead of print]


 

Interleukin-17 cytokine signalling in patients with asthma.
 

Lindén A1, Dahlén B2.
 

ABSTRACT
Asthma remains a global health problem and, therefore, more effective pharmacotherapy is needed. This is particularly true for chronic and severe asthma. In these clinical phenotypes, chronic inflammation involving neutrophils is likely to play a pathogenic role, making it interesting to target cytokine signalling involved in the accumulation of neutrophils. Therefore, it is of interest that the archetype T-helper 17 cell cytokine interleukin (IL)-17A, perhaps also IL-17F, controls neutrophil accumulation, mucus secretion, macrophage mobilisation and smooth muscle reactivity in various experimental airway models. However, much less is known about the involvement of signalling via IL-17 cytokines in humans with asthma. Existing evidence suggests that these cytokines are released from several types of immune cells in asthma and, for IL-17A, there is a local increase associated with disease severity, with the mobilisation of neutrophils and smooth muscle cells locally in the airways. Even though the causative role of IL-17 cytokines remains unclear, there is potential for clinical utility in targeting IL-17A specifically in patients with moderate-to-severe asthma and high reversibility. There is a need for new and well-powered clinical investigations of signalling via IL-17 cytokines in this clinical phenotype.

Eur Respir J. 2014 Jun 12. pii: erj00023-2014. [Epub ahead of print]