转化生长因子β在支气管哮喘气道平滑肌重塑中的作用

支气管哮喘(简称哮喘)是一种气道慢性炎症,持续的气道炎症导致气道重塑、不完全可逆的气流受限和进行性的肺功能受损.平滑肌细胞的增殖(包括增生和肥大)是哮喘气道重塑的特征性改变,是哮喘气道反应性和严重程度相关的重要因素之一.转化生长因子β(TGF-β)能够诱导分化、炎症、增生以及凋亡等多种细胞反应,促进平滑肌细胞的增生、肥大和迁移,在气道重塑中发挥重要作用.减少TGF-β的产生以及控制TGF-β的效应有利于对慢性哮喘气道重塑的干预治疗.     

罗红霉素对支气管哮喘大鼠气道平滑肌细胞凋亡及P27kip-1蛋白表达的影响

气道重塑是支气管哮喘(简称哮喘)除气道慢性炎症以外又一重要病理特征,气道平滑肌细胞(ASMC)在气道重塑的发生、发展中发挥着重要的作用,有学者认为应把ASMC作为哮喘研究的标靶[1].罗红霉素除抗感染作用外,还有免疫调节和抗炎的作用.     

JNK/SAPK信号转导通路及其在支气管哮喘中的作用

支气管哮喘 (哮喘 )是以气道慢性炎症、气道高反应性、气道重塑为特征 ,涉及到嗜酸粒细胞(EOS)、淋巴细胞、肥大细胞、上皮细胞、平滑肌细胞、巨噬细胞等及多种细胞因子、粘附分子、炎症介质 ,构成一个复杂的网络系统 ,而信号转导在其中起着决定性的作用。目前以 β 肾上腺素受体激动剂及糖皮质激素为主的治疗策略使气道的炎症和急性气道高反应 (气道急性收缩 )得到缓解 ,但对于慢性哮喘或气道重塑有很小的作用 ,而且不少患者还存在激素的抵抗、发病率也逐渐上升 ,因此研究针对炎症及气道重塑新的抗哮喘药物已成为热点[1,2 ] 。新的治疗设…     

支气管哮喘气道重塑平滑肌增生机制

支气管哮喘是严重影响人类正常生活的慢性疾病之一,尤其是在气道重塑发生之后.由于气道重塑的不可逆,使支气管哮喘的治疗陷入瓶颈状态.气道重塑最主要的病理学改变为气道平滑肌细胞增殖导致的平滑肌层增厚,其原因是机体慢性炎症和长期免疫应答,那么参与炎症反应和免疫应答的细胞因子以及平滑肌细胞的来源就成为研究气道重塑的重要途径.在此...     

Rho/ROCK信号转导通路与支气管哮喘气道重塑

支气管哮喘(简称哮喘)是多种细胞及其组分参与的慢性非特异性炎症性疾病,气道反复炎症损伤与修复造成的气道重塑是哮喘主要的病理生理学特征,预防气道重塑是哮喘干预治疗的重要潜在靶点,是改善哮喘预后的重要手段.Rho通过激活下游效应物Rho相关卷曲螺旋形成蛋白激酶(Rho associated coiled coil fotruing protein kinase,ROCK)作用于气道平滑肌细胞及调节细胞因子和炎性因子等的产生,在哮喘气道重塑的形成与发展中起关键的作用,ROCK抑制剂能有效抑制哮喘动物模型的气道炎症和气道重塑作用.     

肾素-血管紧张素系统与支气管哮喘

支气管哮喘(哮喘)是全球范围内严重威胁公众健康的慢性疾病之一,是以气道慢性炎症和气道重塑为基本病理特征的慢性疾病.近年来,大量研究显示肾素一血管紧张素系统(renin-angiotensin system,RAS)参与了哮喘的急性发作和气道重塑过程.因此,应用血管紧张素转换酶抑制剂和血管紧张素受体阻断剂治疗和预防哮喘发作,可望成为哮喘治疗的一个重要方法.本文综述了RAS在哮喘发生、发展过程中的作用.     

生长因子与气道重塑——生长因子在支气管哮喘气道重塑过程中作用的新进展

支气管哮喘(简称哮喘)是由多种细胞和细胞组分参与的气道慢性炎症性疾病.气道重塑在哮喘早期即可出现,并随着病情进展而加重,参与了哮喘的整个慢性炎症过程,哮喘症状的持续存在、严重程度及气道高反应性均与气道重塑密切相关.因此,理解气道重塑如何促进哮喘进展就成为了更好治疗和管理疾病的关键.生长因子是一类调节细胞生长、分化的多肽类物质,与生长发育、分化、肿瘤等均有密切关系.近年研究显示多种生长因子参与哮喘气道重塑过程.     

转化生长因子β在支气管哮喘气道平滑肌重塑中的作用

支气管哮喘（简称哮喘）是一种气道慢性炎症,持续的气道炎症导致气道重塑、不完全可逆的气流受限和进行性的肺功能受损。平滑肌细胞的增殖（包括增生和肥大）是哮喘气道重塑的特征性改变,是哮喘气道反应性和严重程度相关的重要因素之一。转化生长因子β（TGF-β）能够诱导分化、炎症、增生以及凋亡等多种细胞反应,促进平滑肌细胞的增生、肥大和迁移,在气道重塑中发挥重要作用。减少TGF-β的产生以及控制TGF-β的效应有利于对慢性哮喘气道重塑的干预治疗。     

哮喘气道重塑发病机制的新进展

支气管哮喘是细胞因子参与调节的,以嗜酸细胞浸润为主的多种细胞参与的一种慢性气道炎症性疾病。其特点是不同程度的可逆性气道阻塞和气道的高反应性。哮喘的发病机制非常复杂,不同类型的哮喘发病机制不尽相同,同种类型的哮喘发病机制亦可不一样。支气管粘膜病理检查证实：哮喘患者即使在缓解期也有气道炎症持续存在,且伴有上皮常纤维化和气道平滑肌增生、肥大［１］,导致气道重塑。这种重塑是由于气道炎症细胞释放各种活性物质导致气道损伤,以及随之而来的修复所致,涉及到气道壁的各层。有研究认为吸入糖皮质激素可预防或治疗气道重…     

Rho／ROCK信号转导通路与支气管哮喘气道重塑

支气管哮喘（简称哮喘）是多种细胞及其组分参与的慢性非特异性炎症性疾病,气道反复炎症损伤与修复造成的气道重塑是哮喘主要的病理生理学特征,预防气道重塑是哮喘干预治疗的重要潜在靶点,是改善哮喘预后的重要手段。Rho通过激活下游效应物Rho相关卷曲螺旋形成蛋白激酶（Rho associated coiled coil forming protein kinase,ROCK）作用于气道平滑肌细胞及调节细胞因子和炎性因子等的产生,在哮喘气道重塑的形成与发展中起关键的作用,ROCK抑制剂能有效抑制哮喘动物模型的气道炎症和气道重塑作用。     

Asthma remission: does it exist?

Subjects believed to have grown out of asthma often develop symptoms again later in life. Ongoing airway inflammation may determine the risk of relapse, although the mechanisms involved are still misunderstood. Additionally, patients with asthma during childhood may develop irreversible airflow obstruction ( airway remodeling) as a result of chronic airway inflammation. Recently, airway inflammation and remodeling could be demonstrated in bronchial biopsy specimens from young adults who considered themselves grown out of asthma. It is also shown that evidence of airway inflammation and remodeling can be obtained noninvasively, thereby providing the opportunity to monitor disease activity. If chronic airway inflammation and/or remodeling are consistent findings in asymptomatic subjects with a history of atopic asthma, the question arises whether natural history can be positively altered with prolonged antiinflammatory therapy. Benefits of long-term prognosis are, however, not yet shown. Since epidemiologic work has demonstrated that a certain percentage of subjects with apparently outgrown atopic asthma remains asymptomatic without needing therapy for the rest of their lives, it can be argued that "asthma remission does exist." The question is whether this percentage can be increased with prolonged antiinflammatory therapy and regular control.     

Airway inflammation and remodeling in asthma

An important advance in our understanding of the pathophysiology of asthma has been the discovery that airway inflammation is not confined to severe asthma but also characterizes mild and moderate asthma. Inflammation in asthma may be the result of a peculiar type of lymphocytic inflammation whereby Th2 lymphocytes secrete cytokines that orchestrate cellular inflammation and promote airway hyperresponsiveness. The term "airway remodeling" in asthma refers to structural changes that occur in conjunction with, or because of, chronic airway inflammation. Airway remodeling results in alterations in the airway epithelium, lamina propria, and submucosa, leading to thickening of the airway wall. The consequences of airway remodeling in asthma may include incompletely reversible airway narrowing, bronchial hyperresponsivenesss, airway edema, and mucus hypersecretion. Airway remodeling in asthma thus may predispose persons with asthma to asthma exacerbations and even death from airway obstruction caused by smooth muscle contraction, airway edema, and mucus plugging. Although much has been learned in the past 25 years about the pathophysiology of airway inflammation and airway remodeling in asthma, important questions remain about the relation between airway inflammation and remodeling, the natural history of airway remodeling, and the effects of current asthma treatments on remodeled airways.     

哮喘神经机制的研究进展

支气管哮喘（哮喘）是全球性的严重健康难题，发病机制错综复杂，至今仍不完全清楚。现在被较多学者接受的理论是气道慢性炎症学说、变态反应学说、气道高反应学说以及气道重构学说。其中气道慢性炎症、高反应性和气道重构均涉及到神经机制的参与。越来越多的研究发现神经机制在哮喘气道高反应性中起至关重要的作用，并与免疫机制相互作用，引起神经源性炎症反应。对神经机制的研究可能成为未来攻克哮喘难关的突破点。     

Mechanisms of airway remodeling in asthma.

Asthma is a chronic inflammatory disease characterized by reversible airflow limitation and airway hyperresponsiveness. Persistent inflammation in airway tissues may lead to structural changes known as airway remodeling and consequently airway obstruction that is not fully reversible and progressive loss of lung function over time. It is generally accepted that airway remodeling is closely related to progression of airway hyperresponsiveness, and the severity of asthma. The structural changes observed in chronic persistent asthma, which includes airway smooth muscle hypertrophy and hyperplasia, collagen deposition to sub-epithelial basement membrane, hyperplasia of goblet cells, thickening of airway mucosa and an increase in vascularity, are derived from airway inflammation. For instance, the thickened airway mucosa might be produced by cytokines and growth factors released from inflammatory cells and airway epithelial cells, and associated with bronchial hyperreactivity and asthma severity. To date, many studies have identified candidate mechanisms and mediators for these observed structural changes, which are thus potential targets in the treatment of asthma. In this review, we describe the recent knowledge of the mechanisms and clinical implications of airway remodeling in asthma.     

支气管哮喘中气道重构的研究状况

支气管哮喘是由嗜酸粒细胞（EOS）、肥大细胞和T细胞等多种炎性细胞参与的气道慢性炎症性疾病,气道重构是在气道炎症基础上气道壁损伤,在多种细胞、炎症介质、生长因子的参与下出现的不完全修复。本文从病理和发生机制的角度对哮喘的气道重构作一综述。     

Inhibitory Effects of Anti-Immunoglobulin E Antibodies on Airway Remodeling in A Murine Model of Chronic Asthma

Background: Airway remodeling is one of the cardinal features of asthma and is thought to play a pivotal role in refractory or persistent asthma. Immunoglobulin E (IgE) has a major effect on the pathogenesis of asthma. The aim of this study was to investigate the effects of anti-IgE antibody not only on airway inflammation and bronchial hyperresponsiveness, but also on airway remodeling in a murine model of chronic asthma. Methods: The authors developed a mouse model of chronic asthma in which ovalbumin (OVA)-sensitized female BALB/c-mice were exposed to intranasal OVA administration twice a week for 3 months. Anti-IgE antibodies were administered intravenously starting on the 38th day and once a month thereafter for 3 months during the intranasal OVA challenge. Results: Mice that were chronically exposed to OVA developed sustained eosinophilic airway inflammation and airway hyperresponsiveness (AHR) to methacholine and showed increased levels of collagen, hydroxyproline, and α-smooth muscle actin, as compared with control mice. Treatment with anti-IgE antibody inhibited the development of AHR, eosinophilic inflammation, and airway remodeling. Moreover, anti-IgE antibody treatment reduced the levels of interleukin (IL)-5 and IL-13 in the bronchoalveolar lavage fluids, although it did not affect the levels of IL-10, transforming growth factor-β, and activin A. Conclusion: These results suggest that anti-IgE antibody treatment modulates the airway inflammation and remodeling associated with chronic allergen challenge. The inhibition of inflammation may be related to the regulation of Th2 cytokines. However, the mechanisms underlying the blocking of airway remodeling by anti-IgE antibody remain to be elucidated.     

Vascular Endothelial Growth Factor as a Key Inducer of Angiogenesis in the Asthmatic Airways

Asthma is a chronic inflammatory disease of the airways characterized by structural airway changes, which are known as airway remodeling, including smooth muscle hypertrophy, goblet cell hyperplasia, subepithelial fibrosis, and angiogenesis. Vascular remodeling in asthmatic lungs results from increased angiogenesis, which is mainly mediated by vascular endothelial growth factor (VEGF). VEGF is a key regulator of blood vessel growth in the airways of asthma patients by promoting proliferation and differentiation of endothelial cells and inducing vascular leakage and permeability. In addition, VEGF induces allergic inflammation, enhances allergic sensitization, and has a role in Th2 type inflammatory responses. Specific inhibitors of VEGF and blockers of its receptors might be useful to control chronic airway inflammation and vascular remodeling, and might be a new therapeutic approach for chronic inflammatory airway disease like asthma.