迷走神经与肺部疾病

 迷走神经支配人体的内脏器官，其传出纤维激活后可释放乙酰胆碱调节器官功能，而传入纤维能感知器官中机械和化学信号，并将其传入中枢，这种双向交流使得神经中枢能够反馈性调节器官功能。在呼吸系统中，迷走神经调节气道张力、血流供应、黏液分泌及呼吸型式。近来发现，迷走神经与免疫系统产生交互作用，在肺部疾病的发病机制中发挥重要作用，如哮喘、慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)、急性呼吸窘迫综合征(acute respirtory distress sydrome,ARDS)、肺纤维化和肺癌。在疾病状态下，多种细胞释放的细胞因子、化学因子和其他介质激活迷走神经，将免疫信息传到中枢，从而改变病程。激活迷走神经还可以释放神经肽调节免疫细胞的活动，并通过胆碱能抗炎通路控制肺部炎症，因此了解迷走神经在神经免疫反应中的作用对于肺部疾病的临床治疗有着重要意义。

The vagus nerve and pulmonary disease

The vagus nerve innervates most visceral organs.Upon activation,vagal efferents release acetylcholine,which influences organ function.In addition,vagal afferents convey information regarding the mechanical and chemical environment of the organ to the central nervous system(CNS).This bidirectional communication provides a mechanism for reflex regulation of the biological function of the organ.In the lung,the vagus nerve modulates airway tone,perfusion and secretion,in addition to its effects on breathing pattern.Recently,the vagus nerve has been recognized to play a role in the pathogenesis of lung disease via neuro-immune interactions.The vagus nerve has significant influences in pulmonary diseases,such as asthma,chronic obstructive pulmonary disease(COPD),acute respiratory distress syndrome(ARDS),pulmonary fibrosis and lung cancer.In disease,the nerve is activated by cytokines,chemokines,and other mediators from many cell types to convey immunologic information to the CNS,which may alter disease outcome.Activation of the vagus nerve also releases neuropeptides to modulate immune cell behavior and can evoke the cholinergic anti-inflammatory pathway that regulates lung inflammation.Understanding the role of the vagus nerve in neuro-immune interaction may contribute significantly to the clinical management of pulmonary diseases.