神经生长因子与哮喘

<正>近年来研究发现哮喘及其他许多致敏性疾病的发病可能与神经生长因子(NGF)直接相关~(〔1〕),同时人们发现NGF与变态反应性和炎症性疾病的发病有关~(〔2〕)。哮喘患者体内存在神经-内分泌-免疫网络失衡,表现为以NGF为主的神经营养因子和神经肽的过度表达。NGF在周围神经系统的交感和感觉神经的生长和分化中发挥重要作用。越来越多的证据表明,NGF是一种多功能的细胞生长和调节因子,除对神经系统的作用     

小气道炎症与哮喘

支气管哮喘是一种气道慢性炎症,在哮喘患者的大小气道都存在着广泛的炎症。本文综述了哮喘小气道肺功能,病理及影像学的研究进展,证明小气道炎症是哮喘的重要特征之一,并阐述小气道病变对哮喘的发生、诊断及治疗的意义。     

小气道炎症与哮喘

本综述了哮喘小气道肺功能,病理及影像学的研究进展,证明小气道炎症是哮喘的重要特征之一,并阐述了小气道病变对哮喘的发生,诊断及治疗的意义。     

神经生长因子对哮喘大鼠气道炎症中TNF-α表达的调节作用

目的 探讨神经生长因子(NGF)在哮喘发病中对气道炎症TNF-α mRNA表达的调节作用.方法 实验分为对照组、哮喘组、NGF阻断组.免疫组化方法结合显微图像分析检测NGF的表达,以及抗NGF干预后哮喘的发作情况、嗜酸性粒细胞及TNF-α mRNA表达的关系.结果 NGF阻断组与哮喘组比较,哮喘发作次数、嗜酸性粒细胞计数显著减少(均P＜0.01),肺组织炎症表现显著减轻.哮喘组大鼠肺组织内NGF mRNA表达水平较对照组显著增高(P＜0.05),NGF阻断组肺组织内TNF蛋白及TNF-a mRNA的表达较哮喘组明显减少(P＜0.05).结论 NGF阻断可减少肺部嗜酸粒细胞浸润、哮喘的发作次数及TNF-α mRNA蛋白的表达,并可以抑制气道炎症.     

神经生长因子与气道重构

气道重构是慢性支气管哮喘(哮喘)的典型病理学改变,其形成与多种细胞因子有关。神经生长因子在哮喘的发病机制中可能充当连接免疫系统和神经系统交互作用的链条,在气道重构等哮喘病理生理过程中起重要作用。     

神经生长因子气道重构

气道重构是慢性支气管哮喘（哮喘）的典型病理学改变，其形成与多种细胞因子有关。神经生长因子在哮喘的发病机制中可能充当连接免疫系统和神经系统交互作用的链条，在气道重构等哮喘病理生理过程中起重要作用。     

支气管哮喘与气道炎症和支气管高反应性

现已普遍认为支气管哮喘是一种气道炎症（ＡＩ）疾病，支气管高反应性（ＢＨＲ）是其重要特征。本探讨了哮喘与ＡＩ和ＢＨＲ的关系，进而阐述哮喘的可能发病机制。     

白三烯—哮喘气道炎症及重塑的重要介质

白三烯是哮喘发病过程中最重要的炎症介质之一，它不仅能收缩气道平滑肌，且具有促进炎症细胞在气道集及促进气道结构细胞增殖等作用，从而参与气道炎症及重塑的发生过程。以下就ＬＴｓ在哮喘气道炎症及重塑过程中的作用作一综述。     

支气管哮喘气道炎症可能机制的探讨

目的探讨支气管哮喘（简称哮喘）患者气道炎症特征及其可能机制,并进一步观察吸入糖皮质激素治疗对气道炎性细胞分类计数、炎症介质等的影响。方法分别选择轻度（轻度组）、中度（中度组）和重度（重度组）持续哮喘患者15例、14例和19例,正常对照组15名,分别行哮喘症状控制评分、肺功能测定、诱导痰炎性细胞分类计数、调节激活正常T细胞表达和分泌细胞因子（RANTES）、嗜酸粒细胞阳离子蛋白（ECP）、白介素8（IL～8）及髓过氧化物酶（MPO）浓度检测,然后规范吸入糖皮质激素治疗4周,随访复查上述指标。结果诱导痰中性粒细胞百分比、IL-8及MPO重度组明显升高,分别为（62．40±22．05）％、594．53±85．11、39．25±10．67与轻度组[（47．23±15．12）％、183．63±120．98、12．47±4．15]、中度组[（46．13±19．23）％、352．76±71．72、22．93±7．353、正常对照组[（31．44±13．31）％、103．26±36．33、10．22±4．13]比较差异均有统计学意义（P〈O．01）;RANTES、嗜酸粒细胞百分比（EOS％）和ECP浓度在各哮喘组间比较差异无统计学意义（P〉0．05）。EOS％与RANTES、ECP水平呈正相关（r=0．557,P〈0．05;r=0．852,P〈0．01）;中性粒细胞百分比与IL-8、MPO水平呈正相关（r=0．732,P〈0．05;r=0．806,P〈0．05）;经糖皮质激素治疗后,对轻、中、重度哮喘患者合并进行分析表明,治疗后症状评分由（9．8±5．4）分下降至（4．0±3．5）分和肺功能指标第1秒用力呼气容积占预计值百分比由（62．2±23．3）％升高至（75．9±17．5）％显著改善,差异有统计学意义（P〈0．01）。在接受糖皮质激素治疗后,RANTES、EOSO和ECP水平均显著降低。另外MPO水平也显著降低（P〈0．01）;但治疗后在重度组仍显著高于轻、中度组（P〈0．01）。但IL-8、中性粒细胞百分比治疗后?     

神经生长因子与支气管哮喘

神经生长因子(nerve growth factor,NGF)对神经细胞的生长、分化、存活、维持均起着重要作用,NGF还通过调节多种免疫细胞,促进炎性介质释放,导致气道炎症,诱导神经元可塑性.NGF水平在支气管哮喘患者血清、痰液、支气管肺泡灌洗液、支气管黏膜中均有明显升高.本文就NGF的生物学特征、调节以及与支气管哮喘的3个主要特征气道炎症、气道高反应性和气道重塑的关系作一综述.     

神经生长因子与咳嗽变异性哮喘

咳嗽变异性哮喘是指以慢性咳嗽为主要或惟一临床表现的一种特殊类型的哮喘.目前发病机制尚不十分清楚.神经生长因子(nerve growth factor,NGF)是神经营养家族中成员之一.随着NGF在慢性咳嗽患者诱导痰中的发现,对NGF在咳嗽变异性哮喘发病机制中的作用引起人们的重视.研究发现,NGF是一种多功能的细胞生长和调节因子,对免疫细胞的生长、分化、激活可产生重要影响,从而参与咳嗽变异性哮喘的免疫失衡.因此,NGF是联系免疫细胞与神经细胞之间的双向信号分子.因而对NGF的研究,有助于探讨咳嗽变异性哮喘发病机制.     

Markers of airway inflammation and airway hyperresponsiveness in patients with well-controlled asthma.

In steroid-naive asthmatics, airway hyperresponsiveness correlates with noninvasive markers of airway inflammation. Whether this is also true in steroid-treated asthmatics, is unknown. In 31 stable asthmatics (mean age 45.4 yrs, range 22-69; 17 females) taking a median dose of 1,000 microg inhaled corticosteroids (ICS) per day (range 100-3,600 microg x day(-1)), airway responsiveness to the "direct" agent histamine and to the "indirect" agent mannitol, lung function (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF)), exhaled nitric oxide (eNO), and number of inflammatory cells in induced sputum as a percentage of total cell count were measured. Of the 31 subjects, 16 were hyperresponsive to mannitol and 11 to histamine. The dose-response ratio (DRR: % fall in FEV1/cumulative dose) to both challenge tests was correlated (r=0.59, p=0.0004). However, DRR for histamine and DRR for mannitol were not related to basic lung function, eNO, per cent sputum eosinophils and ICS dose. In addition, NO was not related to basic lung function and per cent sputum eosinophils. In clinically well-controlled asthmatics taking inhaled corticosteroids, there is no relationship between markers of airway inflammation (such as exhaled nitric oxide and sputum eosinophils) and airway responsiveness to either direct (histamine) or indirect (mannitol) challenge. Airway hyperresponsiveness in clinically well-controlled asthmatics appears to be independent of eosinophilic airway inflammation.     

神经生长因子、白血病抑制因子调控支气管哮喘大鼠神经源性炎症机制的研究

目的研究神经生长因子(NGF)、白血病抑制因子(LIF)调控支气管哮喘(简称哮喘)大鼠气道神经源性炎症的机制,寻求治疗哮喘的新靶点。方法成年清洁级雄性SD大鼠36只,按随机数字表法分为对照组、哮喘组和抗NGF组,每组12只。采用免疫组织化学和原位杂交技术观察哮喘大鼠肺组织、C7～T5背根神经节内NGF、LIF、P物质(SP)的表达状态及抗NGF干预对其表达的影响。结果(1)哮喘组大鼠肺组织NGF、LIF蛋白及其mRNA的平均灰度值分别为157±7、138±8、156±6、141±10,对照组分别为183±7、190±7、187±7、181±8,抗NGF干预组分别为177±6、169±9、178±7、172±9,三组比较差异有统计学意义(t分别=19.40、15.80、0.38、14.79,P均<0.01);(2)哮喘组大鼠C7～T5背根神经节NGF、LIF、SP蛋白及SPmRNA的灰度值分别为136±8、148±6、140±8、128±8,对照组分别为185±7、187±8、174±7、180±8,抗NGF干预组分别为164±6、170±8、163±9、157±7,三组比较差异有统计学意义(t分别=29.50、22.65、23.12、28.71,P均<0.01)。结论促进背根神经节细胞合成和释放SP可能是NGF、LIF参与哮喘气道神经源性炎症形成的机制之一,抗NGF干预能够有效地将其抑制。     

Smoking and airway inflammation in patients with mild asthma.

STUDY OBJECTIVES: Cigarette smoking is common in asthmatic patients, and we investigated the impact of cigarette smoking on airway inflammation in asthma. DESIGN: Single-center observational study of airway inflammation in asthmatic and healthy smokers and nonsmokers. SETTING: Asthma research unit in a university hospital. PATIENTS OR PARTICIPANTS: Sixty-seven asthmatic and 30 nonasthmatic subjects classified as smokers or nonsmokers. Asthmatics had chronic, stable asthma and were not receiving inhaled or oral steroids at the time of the study. INTERVENTIONS: We examined induced-sputum cell counts and levels of interleukin (IL)-8 and eosinophilic cationic protein (ECP). Bronchial hyperreactivity was assessed using methacholine challenge. MEASUREMENTS AND RESULTS: Asthmatic smokers had higher total sputum cell counts than nonsmoking asthmatics and both smoking and nonsmoking healthy subjects. Smoking was associated with sputum neutrophilia in both asthmatics and nonasthmatics (median, 47% and 41%, respectively) compared with nonsmokers (median, 23% and 22%, respectively), and sputum IL-8 was increased in smokers compared with nonsmokers, both in subjects with asthma (median, 945 pg/mL vs 660 pg/mL, respectively) and in healthy subjects (median, 1,310 pg/mL vs 561 pg/mL, respectively). Sputum eosinophils and ECP levels were higher in both nonsmoking and smoking asthmatics than in healthy nonsmokers. In smoking asthmatics, lung function (FEV(1) percent predicted) was negatively related to both sputum IL-8 (r = - 0.52) and sputum neutrophil proportion (r = - 0.38), and sputum IL-8 correlated positively with smoking pack-years (r = 0.57) and percent neutrophil count (r = 0.51). CONCLUSIONS: In addition to the eosinophilic airway inflammation observed in patients with asthma, smoking induces neutrophilic airway inflammation; a relationship is apparent between smoking history, airway inflammation, and lung function in smoking asthmatics.     

神经生长因子及其在支气管哮喘中的研究进展

支气管哮喘(简称哮喘)作为呼吸系统中呈逐年上升趋势的一种常见病,给人类社会及家庭均带来了严重的经济负担.尽管激素的使用对哮喘患者的症状有所控制,但激素敏感的出现等,使其发病率和病死率只增不减,追根溯源还是对哮喘的发病机制不完全了解所致,故完善其发病机制的研究,将开拓新的诊疗方向.随着现代分子生物学的发展,目前发现神经生长因子在哮喘的发生发展中起着核心作用,有学者提出了哮喘的“免疫-神经-内分泌网络”的概念,通过多系统的联系,使人们对哮喘的发病机制有了更深的认识,或许将开拓哮喘研究及治疗的新领域.     

血管内皮生长因子受体抑制剂对小鼠支气管哮喘模型气道炎症和气道重塑的影响

目的研究血管内皮生长因子(VEGF)受体抑制剂对变应性气道炎症和气道重塑的影响,阐明VEGF与支气管哮喘(简称哮喘)以及气道重塑的关系。方法BALB/c小鼠按随机数字表法分为正常对照组(A组)、哮喘模型组(B组)、VEGF受体抑制剂治疗组(C组),每组各10只。用酶联免疫吸附测定(ELISA)法对各组小鼠支气管肺泡灌洗液(BALF)和血清中VEGF进行定量分析;用免疫组化法检测VEGF在小鼠肺组织内的表达水平。采用医学图像分析软件测定支气管管壁厚度(WAt/P i)、支气管平滑肌厚度(WAm/P i)、支气管平滑肌细胞计数(N/P i)及肺组织切片中的血管计数、血管壁平滑肌厚度、血管壁平滑肌细胞计数。结果BALF中细胞总数和嗜酸粒细胞比值B组分别为(142±63)×107/L、98.0±46.9,A组分别为(30±14)×107/L、0.7±1.1,C组分别为(41±17)×107/L、4.9±3.5,A组和C组BALF中细胞总数和嗜酸粒细胞比值分别与B组比较差异有统计学意义(P均<0.01)。B组BALF中上清液和血清中VEGF水平分别为(55±26)pg/m l、(72±26)pg/m l,A组分别为(37±9)pg/m l、(49±18)pg/m l,C组分别为(34±3)pg/m l、(43±19)pg/m l,A组与B组、C组与B组间比较差异均有统计学意义(P均<0.05)。免疫组化结果显示,B组大部分支气管平滑肌、黏膜上皮细胞、肺泡上皮细胞和血管周围VEGF均呈阳性表达,而A组和C组几乎没有VEGF的表达。图像分析显示,B组WAt/P i、WAm/P i、N/P i分别为(17±5)μm2/μm、(6.3±2.2)μm2/μm、(0.050±0.020)个/μm,A组分别为(8±3)μm2/μm、(3.2±0.8)μm2/μm、(0.027±0.017)个/μm,A组与B组比较差异有统计学意义(P分别<0.01、0.05)。B组和A组血管计数分别为(19±3)个、(10±5)个,A组与B组比较差异均有统计学意义(P<0.01)。经抑制剂治疗后C组WAm/P i、血管计数分别为(4.5±1.3)μm2/μm、(11±3)个,C组与B组比较差异均有统计学意义(P均<0.05)。结论VEGF在小鼠哮喘模型气道及肺内过度表达,并参与了哮喘的发病和气道重塑过程。VEGF受体抑制剂可明显改善哮喘小鼠的变应性气道炎症和气道重塑的病理生理过程。     

Pharmacology of airway inflammation in asthma

Chronic desquamative eosinophilic bronchitis is a characteristic pathologic feature of asthma which may even antedate the onset of symptoms. The pharmacology of asthmatic inflammation has been relatively poorly studied and most of the current data available have been inferred indirectly from studies of bronchial hyperresponsiveness and late-phase responses. Apart from mast cells, the effects of drugs used in the treatment of asthma on other airway inflammatory cells such as eosinophils, alveolar macrophages, etc. have not been extensively studied. The pharmacology of asthmatic inflammation should comprise the study of various aspects of this inflammatory response such as airway microvascular leakage, mediator release, and cell chemotaxis. Ultimately the pharmacologic modulation of the pathologic features of the asthmatic airway by the chronic use of antiasthma drugs, coupled with clinical responses, need to be investigated using bronchial biopsies and broncholveolar lavage in asthmatic patients.     

Singlet oxygen -derived nerve growth factor exacerbates airway hyperresponsiveness in a mouse model of asthma with mixed inflammation

BackgroundRefractory asthma, which is caused by several factors including neutrophil infiltration is a serious complication of bronchial asthma. We previously reported that nerve growth factor (NGF) is involved in AHR. NGF-derived induction of hyperalgesia is dependent on neutrophils; however, this relationship remains unclear in respiratory disease. In this study, we examined the roles of neutrophils and NGF in refractory asthma.MethodsUsing intranasal house dust mite sensitization, we established a mouse model of asthma with mixed inflammation (Mix-in). AHR, NGF production and hyperinnervation of the lungs were examined with or without different inhibitory treatments. The levels of the singlet oxygen markers, 10- and 12-(Z,E)-hydroxyoctadecadienoic acids (HODE) in the lungs, were measured by liquid chromatography-tandem mass spectrometry. An in vitro experiment was also performed to evaluate the direct effect of singlet oxygen on NGF production.ResultsNGF production and hyperinnervation were higher in Mix-in mice than in conventional eosinophilic-asthmatic mice and were positively correlated with AHR. Asthmatic parameters were inhibited by NGF neutralizing Abs and myeloperoxidase (MPO) inhibition. The 10- and 12-(Z,E)-HODEs levels were increased in the lungs and were positively correlated with MPO activity and NGF production. NGF was produced by bronchial epithelial cells in vitro upon stimulation with singlet oxygen.ConclusionsOur findings suggest that neutrophil MPO-derived singlet oxygen induces increased NGF production, leading to AHR and 10- and 12-(Z,E)-HODEs production. These findings may help to develop new therapies targeting this mechanism and to establish a new biomarker for non-type 2 and refractory asthma.