含人基质金属蛋白酶组织抑制因子-1重组腺病毒的构建与体外表达

从人肝癌组织中提取总RNA，RT—PCR合成hTIMP-1的全长cDNA，克隆到腺病毒载体AdEasy系统的穿梭质粒pAdTraek—CMV上，与骨架质粒pAdEasy-1在BJ5183受体菌中进行同源重组，成功构建含hTIMP-1全长eDNA的重组腺病毒载体，经293细胞的包装、扩增，生成含hTIMP-1基因的重组腺病毒AdhTIMP-1并实现体外表达，为进一步研究肝癌浸润和转移机理以及肝癌的基因治疗提供实验基础。     

人组织金属蛋白酶抑制因子-3的分离纯化及其生物学性质

目的:从人胎盘中分离、纯化组织金属蛋白酶抑制因子3(TIMP3),并对其对基质金属蛋白酶1(MMP1)的抑制作用进行评价。方法:利用含4mol/L尿素的TrisHCl缓冲液(pH8.0),从除去多数水溶性蛋白的胎盘匀浆液中提取难溶性蛋白。经CM52阳离子交换树脂和SephacrylS200凝胶过滤两步柱层析纯化后,用SDSPAGE鉴定TIMP3的纯度;用EIA和Westernblot检测TIMP3的含量;用免疫荧光测定法检测TIMP3对MMP1的抑制活性。结果:人胎盘来源的TIMP3由相对分子质量(Mr)为24000的非糖化蛋白和Mr为27000的糖化蛋白组成。非糖基化的TIMP3对MMP1的IC50为1.1×10-10mol/L,糖基化的TIMP3为1.2×10-10mol/L,显著高于重组的TIMP3(IC50为8×10-8)。结论:人胎盘来源的TIMP3由Mr为24000的非糖基化蛋白和Mr为27000的糖基化蛋白两部分组成,二者对MMP1均具有明显的抑制作用。     

基质金属蛋白酶-9及金属蛋白酶组织抑制因子-1在妊娠期高血压疾病患者胎盘组织中的表达

目的通过研究基质金属蛋白酶-9（MMP-9）及金属蛋白酶组织抑制因子-1（TIMP-1）在正常妊娠和妊娠期高血压疾病患者胎盘中的表达,探讨其与妊娠期高血压疾病发病机制的关系。方法收集山西医科大学第一医院产科和山西中医学院中西医结合医院产科住院分娩的产妇胎盘标本共142例,正常妊娠胎盘组织标本40例为对照组,妊娠期高血压疾病患者胎盘组织标本102例为病例组,通过免疫组织化学二步法,对MMP-9和TIMP-1在胎盘组织中的表达进行检测。结果1.MMP-9及TIMP-1在胎盘组织中的表达部位。在正常妊娠胎盘组织的滋养细胞、蜕膜细胞、间质细胞和血管内皮细胞胞浆中均可见MMP-9、TIMP-1的阳性表达,多为中度阳性和强阳性表达,但在妊娠期高血压疾病患者胎盘组织中,MMP-9未见间质细胞和血管内皮细胞有阳性表达,且表达者多为弱阳性。2.MMP-9在妊娠期高血压疾病患者中的阳性表达与正常妊娠组相比,差异有显著性（P〈0.05）,妊娠期高血压、子痫前期轻度、子痫前期重度组间比较差异有显著性（P〈0.05）。即妊娠期高血压疾病患者胎盘中MMP-9的表达显著低于正常妊娠,且随着妊娠期高血压疾病病情加重,MMP-9阳性表达呈明显减少趋势。3.TIMP-1在正常妊娠和妊娠期高血压疾病患者胎盘中的表达相比较,差异无显著性（P〉0.05）。结论MMP-9表达降低、MMP-9与TIMP-1的平衡状态改变可能与妊娠期高血压疾病发病有关,MMP-9及TIMP-1作为一对相互制约的因素在妊娠期高血压疾病发病中可能起重要作用,MMP-9有望成为妊娠期高血压疾病诊断及判断预后的新指标。     

基质金属蛋白酶与胎膜早破

胎膜早破（preterm premature of the fetal membranes，PROM）和足月前胎膜早破（P—PROM）是威胁母婴健康的常见并发症。PROM的发生率是10％；P—PROM的发生率是2％-3.5％，30％-40％的早产与此有关，而85％的新生儿发病率和死亡率由早产引起。胎膜破裂后，由于屏障作用消失，将可能引起羊膜腔感染、围产期感染、败血症、新生儿窒息等严重的并发症，如果处理不当可危及母儿安全与健康，因此PROM一直受到产科界的关注。     

心房纤颤模型犬心房组织基质金属蛋白酶9及组织抑制因子1与纤维化的关系***

背景：基质金属蛋白酶及其组织抑制因子在心房组织中的相互作用及动态平衡与心房纤颤的发生及维持密切相关。 目的：构建持续性心房纤颤犬模型,观察其心房肌组织基质金属蛋白酶9及其组织抑制因子1的基因表达与心房纤颤及心肌纤维化的关系。 方法：采用慢性快速心房起搏诱发持续性心房纤颤犬模型,并设置假手术组。通过Masson三色法染色计算胶原容积分数来评估纤维化程度,左心房心肌基质金属蛋白酶9及组织抑制因子1的mRNA水平表达使用反转录聚合酶联反应检测,其蛋白水平表达通过蛋白质印迹法测定。 结果与结论：与假手术组相比,持续性心房纤颤模型组心房肌纤维化程度明显增高,胶原容积分数明显增加(P < 0.01),且基质金属蛋白酶9 mRNA及蛋白表达水平明显增加(P < 0.01),组织抑制因子1的mRNA及蛋白表达水平明显下降        (P < 0.01)。结果证实,心房纤颤心房组织中基质金属蛋白酶9/组织抑制因子1基因表达的调控失衡以及基质金属蛋白酶9活性的增高与组织抑制因子1活性降低可能是影响胶原代谢、促进或抑制心肌纤维化,造成心房纤颤时心房结构重构的分子机制之一。     

HBV基因组转染对小鼠NIH3T3细胞内基质金属蛋白酶组织抑制因子的转录调控作用

ObjectiveTo understand the mechanism of liver cirrhosis after the infection of hepatitis B virus.MethodsMouse fibroblast NIH3T3 cells were transfected with 3.2 kb HBV DND by exposure of the cells to calcium phosphate.The change of the levels of mRNA for tissue inhibitor of metalloproteinase 1and 2(TIMP1,2) was detected in mouse fibroblast NIH3T3 cells and the cells of transfection with HBV Genome by in situ hybridization.ResultsThe levels of mRNA for TIMP1 and TIMP2 were increased significantly.ConclusionHBV infection can induce the expression of the mRNA for TIMP1 and TIMP2.     

丁苯酞预处理对脑缺血再灌注损伤大鼠基质金属蛋白酶-9、基质金属蛋白酶组织抑制因子-1和血脑屏障的影响

目的:探讨丁苯酞预处理对脑缺血再灌注损伤大鼠基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制因子-1(TIMP-1)和血脑屏障的影响.方法:90只雄性SD大鼠随机分为假手术组,模型组,NBP预处理低剂量组、中剂量组、高剂量组.采用线栓法制作大脑中动脉栓塞(MCAO)模型,缺血2h再灌注24 h后以干湿重法测定脑组织含水量,伊文思蓝(EB)评估血脑屏障的破坏程度,实时PCR检测MMP-9及TIMP-1 mRNA的表达水平.结果:脑缺血再灌注后,脑组织含水量及EB含量明显增加,MMP-9和TIMP-1表达均增强,与假手术组比较差异有统计学意义.丁苯酞预处理各组脑组织含水量及EB含量较模型组明显下降,MMP-9表达显著减少,TIMP-1表达明显增加,丁苯酞预处理中、高剂量组差异无统计学意义.结论:丁苯酞预处理对脑缺血再灌注损伤大鼠可通过调节MMP-9/TIMP-1的表达,降低血脑屏障通透性,减轻脑水肿,发挥预防性保护作用.     

基质金属蛋白酶及其组织抑制因子在皮肤增生性瘢痕中的作用

目的探讨基质金属蛋白酶（MMPs）MMP2、MMP9及其抑制物（TIMPs）TIMP-1在皮肤增生性瘢痕中的作用。方法取3-6个月、6-12个月皮肤增生性瘢痕，以正常皮肤组织为对照，ELISA方法测定其MMP2、MMP9以及TIMP-1的含量，采用SPSS统计软件，以成组设计的单因素方差分析，分析它们在不同时段瘢痕组织中变化的意义。结果（1）3-6月瘢痕组织和6-12月瘢痕组织的MMP2，均较正常皮肤显著增高（110.70±5.23ng／ml VS 54.59±3.01，P〈0.01；77.23±7.10ng／ml VS 54.59±3.01，P〈0.01），而3-6月瘢痕组织的MMP2较6-12月瘢痕组织的MMP2亦有显著增高（110.70±5.23 VS 77．23±7．10，P〈0．01）；3-6月瘢痕组织和6-12月瘢痕组织的MMP9之间（3.85±0.88 VS 3.61±0.43，P〉0.05）以及它们与正常皮肤组织的MMP9相比（3.85±0.88 VS 4.13±0.33，P〉0.05；3.61±0.43 VS 4.13±0.33，P〉0.05）均无显著性差异；（2）3-6月瘢痕组织和6-12月瘢痕组织的TIMP-1与正常皮肤组织相比有显著增高（4．74±0．35 VS 3．01±0．11，P〈0．01；5．12±0．34 VS 3.01±0．11，P〈0．01），6-12月瘢痕组织较3-6月瘢痕组织的TIMP-1有显著增高（5.12±0.34 VS 4.74±0．35，P〈0．05）；（3）3-6月瘢痕组织和6-12月瘢痕组织的MMP2与TIMP-1的比值与正常皮肤组织相比均有显著增高（23．38±1．01 VS 18．15±0．58，P〈0.01；15.10±1.45 VS 18．15±0．58，P〈0．01），3-6月瘢痕组织较6-12月瘢痕组织的MMP2与TIMP-1的比值有显著降低（23.38±1.01 VS 15.10±1.45，P〈0.01）。结论MMPs以及TIMPs参与了皮肤瘢痕的增生过程，MMP2、TIMP-1含量及其比值可作为瘢痕生长和预后的指标。     

肺间质纤维化大鼠肺组织基质金属蛋白酶及其组织抑制因子含量变化

观察肺纤维化形成过程中基质金属蛋白酶（Matrix Metallo proteinas简称MMPs)及其组织抑制因子（Tissue inhibitors of Metallo proteinases简称TIMPs)含量的变化,探讨其在肺纤维化发病中的作用。将Wistar大鼠60只,随机均分为对照组及模型组,气管内注入博莱霉素A5 5mg/kg,制备肺间质纤维化动物模型,观察注药后1、3、7、14及28d肺脏病理变化,利用酶谱法及免疫印记法分析肺组织MMP－2、MMP－9、TIMP－1的含量变化。结果显示各模型组pro-MMP-2、MMP－2、TIMP－1蛋白含量均较对照组增加,尤其7、14及28d组MMP－2较前明显增多。而MMP－9变化不很明显。提示在肺纤维化形成过程中,pro-MMP-2、MMP－2及TIMP－1都有所增高,MMP／TIMP比例失衡是最终导致肺间质纤维化形成的重要因素。     

急性冠状动脉综合征患者血浆基质金属蛋白酶及其抑制因子的变化

目的：研究急性冠状动脉综合征患者血浆基质金属蛋白酶（MMP-9）及其抑制因子（TIMP-1）的变化。方法：采用夹心酶免疫定量分析技术,测定30例急性冠状动脉综合征患者、29例稳定型心绞痛患者和17例正常对照血浆MMP-9和TIMP-1的变化。结果：3组间年龄、性别、总胆固醇、甘油三脂、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇无显著差异。急性冠脉综合征组高敏C反应蛋白(4.336±1.334)mg/L、MMP-9(13.145±9.796)μg/L、TIMP-1(1.363±0.605)μg/L、MMP-9/TIMP-1(10.013±7.195)显著高于稳定型心绞痛组[分别为(2.205±0.458)mg/L、(2.206±1.996)μg/L、(0.688±0.389)μg/L和(3.249±1.987)]和正常对照组[分别为(1.625±0.434)mg/L、(1.663±1.271)μg/L、(0.583±0.421)μg/L和(5.169±7.416)],MMP-9与hs-CRP、TIMP-1、MMP-9/TIMP-1呈正相关。结论：急性冠脉综合征患者存在着由炎症反应导致的以MMP-9升高为主的MMP-9/TIMP-1失衡状态,血浆MMP-9/TIMP-1有可能作为反映急性冠脉综合征患者脆性斑块的指标。     

基质金属蛋白酶MMP-7及其抑制因子TIMP-1在子宫内膜异位症中的表达及意义

目的 观察基质金属蛋白酶-7(matrix metalloproteinase-7,MMP-7)和基质金属蛋白酶抑制因子-1(tissue inhibitors of matrix metalloproteinase-1,TIMP-1)在子宫内膜异位症(Endmetriosis,EMs)中的表达,探讨二者在EMs发病机制中的作用.方法 采用免疫组化链霉菌抗生物素蛋白-过氧化物酶连接(SP)法检测35例EMs患者的在位内膜,异位内膜及20例时照组为因肌壁间或浆膜下子宫肌瘤在我科行子宫切除术,且月经周期正常的子宫内膜中MMP-7和TIMP-1表达情况,检测结果采用SPSS软件进行统计学分析.结果 MMP-7在EMs在位内膜中的阳性表达率为57.1%,异位内膜中的阳性表达率45.7%,与对照组子宫内膜组织的表达(阳性率为40.0%)相比无显著性差异(P＞0.05).研究组异位内膜中的表达强度明显高于对照组,两者比较,差异有统计学意义(P＜0.05).TIMP-1在两组所有标本中均有阳性表达.TIMP-1在研究组异位内膜中的表达强度低于在位内膜,两者比较,差异有统计学意义(P＜0.05).研究组在位内膜中的表达强度稍低于对照组,两组比较,差异无统计学意义(P＞0.05).结论 MMP-7在EMs的发生过程中起了重要作用.MMP-7在位内膜中表达增强,异位内膜TIMP-1表达减弱,是EMs患者在位内膜、异位内膜细胞具有侵袭能力的原因之一.     

Gelatinases and their tissue inhibitors during human ovulation: increased expression of tissue inhibitor of matrix metalloproteinase-1

Remodelling of the extracellular matrix (ECM) of the follicular wall by matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) has been suggested to be crucial in ovulation. To investigate the expression of the gelatinases, MMP-2 and MMP-9, together with their inhibitors, TIMP-2 and TIMP-1, in the perifollicular ovarian stroma from women just before and during ovulation, we obtained biopsies of the stroma adjacent to the leading follicle. Laparoscopic surgery was performed either before the LH peak or at any of three intervals after ovulation triggering by hCG. Immunoblotting, immunohistochemistry and quantitative RT-PCR were performed. All four proteins were expressed by immunoblots, with no detectable changes in the expression of MMP-2, MMP-9 and TIMP-2. Scattered immunostaining for MMP-9 and TIMP-2 was seen, and MMP-2 was demonstrated in a concentric layer. A significant increase in TIMP-1 protein and mRNA was seen during the three ovulatory phases, and a strong and patchy immunostaining for TIMP-1 was shown. This is the first study that has demonstrated an ovulation-associated expression of these ECM-remodelling enzymes around the human follicle at ovulation. The increased expression of TIMP-1 may reflect a specific temporal inhibition of collagenolysis and thereby a time-dependent regulation of ECM breakdown in areas surrounding the apex of the follicle.     

Children with stable asthma have reduced airway matrix metalloproteinase-9 and matrix metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio

BACKGROUND: Childhood asthma is characterized by inflammation of the airways. Structural changes of the airway wall may also be seen in some children early in the course of the disease. Matrix metalloproteinases (MMPs) are key mediators in the metabolism of the extracellular matrix (ECM). OBJECTIVE: To investigate the balance of MMP-8, MMP-9 and tissue inhibitor of metalloproteinases (TIMP)-1 in the airways of children with asthma. METHODS: One hundred and twenty-four children undergoing elective surgical procedures also underwent non-bronchoscopic bronchoalveolar lavage (BAL). MMP-8, MMP-9 and TIMP-1 were measured by ELISA. RESULTS: There was a significant reduction in MMP-9 in atopic asthmatic children (n=31) compared with normal children (n=30) [median difference: 0.57 ng/mL (95% confidence interval: 0.18-1.1 ng/mL)]. The ratio of MMP-9 to TIMP-1 was also reduced in asthmatic children. Levels of all three proteins were significantly correlated to each other and to the relative proportions of particular inflammatory cells in BAL fluid (BALF). Both MMP-8 and MMP-9 were moderately strongly correlated to the percentage neutrophil count (r=0.40 and 0.47, respectively, P<0.001). CONCLUSIONS: An imbalance of MMPs and their inhibitors occurs in children with well-controlled asthma, which may indicate early derangement of the metabolism of the ECM.     

Coordinate regulation of matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1 expression in human vascular smooth muscle cells

The expression of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) by human vascular smooth muscle cells (SMC) was monitored as a function of the phenotypic modulation in vitro. Cell phenotype was manipulated by varying serum concentration and cell density. Synthetic phenotype was characterized by a minimum expression of the contractile proteins and a maximal proliferation rate. Contractile phenotype was quiescent and expressed a maximal level of contractile proteins. Synthetic cells expressed the highest levels of both MMP-1 and TIMP-1 and displayed maximal collagenolytic activity. No significant change was detected in MMP-2 expression or catalytic activity. Enzyme immunoassays revealed that MMP-1 expression fell by 77+/-2.4-95+/-0.5%, and that of TIMP-1 by 34+/-0.5-59+/-1.9%, as the cells acquired a contractile phenotype. The level of the MMP-1/TIMP-1 complex was similarly reduced by 78+/-2.9-85+/-1.6%. These data demonstrate that the expression of MMP-1 and TIMP-1 are coordinately regulated with SMC phenotype.     

基质金属蛋白酶-9及其组织抑制物-1在人胎盘的表达及意义

目的研究基质金属蛋白酶-9(matrix metalloproteinases,MMP-9)及其组织抑制物-1(tissue inhibitor of metalloproteinases,TIMP-1)在不同孕期胎盘中的表达及与滋养层细胞侵蚀、子宫-胎儿血管系统建立的关系.方法应用原位杂交法检测56例胎盘(早孕16 例、中孕20 例、晚孕20例)中MMP-9及TIMP-1mRNA的表达.结果 MMP-9及TIMP-1mRNA主要表达于滋养细胞、绒毛间质血管壁及蜕膜组织中;MMP-9mRNA的表达早、中孕组明显强于晚孕组,TIMP-1mRNA的表达晚孕组明显强于早、中孕组,差异均有极显著性(P<0.01).结论 MMP-9及TIMP-1协同表达可能在滋养层细胞侵蚀、孕卵着床、血管重建过程中发挥一定的作用.     

Amelioration of coxsackievirus B3-mediated myocarditis by inhibition of tissue inhibitors of matrix metalloproteinase-1

Coxsackievirus B3 (CVB3) is a major cause of acute myocarditis, a serious condition that is refractory to treatment. Myocardial damage results in tissue remodeling that, if too extensive, may contribute to disease. Remodeling is achieved by extracellular proteolysis mediated by the matrix metalloproteinases (MMPs), and MMP activity is counterbalanced by tissue inhibitors of MMPs (TIMPs). We show herein that TIMP-1 expression is induced in the myocardium by CVB3 infection. Surprisingly, TIMP-1 knockout mice exhibited a profound attenuation of myocarditis, with increased survival. The amelioration of disease in TIMP-1 knockout mice was not attributable to either an altered T-cell response to the virus or to reduced viral replication. These data led us to propose a novel function for TIMP-1: its highly localized up-regulation might arrest the MMP-dependent migration of inflammatory cells at sites of infection, thereby anatomically focusing the adaptive immune response. The benefits of TIMP-1 blockade in treating viral myocarditis were confirmed by administering, to wild-type animals, TIMP-1-specific siRNA or polyclonal antisera, both of which diminished CVB3-induced myocarditis. These unexpected findings indicate that increased TIMP-1 expression exacerbates, rather than ameliorates, CVB3-induced myocarditis and, thus, that TIMP-1 may represent a target for the treatment of virus-induced heart disease.     

Matrix metalloproteinase-9 and tissue inhibitor of matrix metalloproteinase-1 in the respiratory tracts of human infants following paramyxovirus infection

Respiratory syncytial (RSV) and parainfluenza (PIV) viruses are primary causes of acute bronchiolitis and wheezing illnesses in infants and young children. To further understand inflammation in the airways following infection, we tested for the presence of matrix metalloproteinases (MMP) and natural tissue inhibitors of MMP (TIMP) in primary and established human cell lines, and in the nasopharyngeal secretions (NPS) of human infants infected with RSV or PIV. Using ELISA and multiplex-based assays, MMP-9 and TIMP-1 proteins were, respectively, detected in 66/67 and 67/67 NPS. During PIV or RSV infection TIMP-1 concentrations were associated with hypoxic bronchiolitis. TIMP-1 amounts were also negatively correlated with O2 saturation, and positively correlated with IL-6, MIP-1alpha, and G-CSF amounts following RSV infection. IL-6, MIP-1alpha, and G-CSF were negatively correlated with O2 saturation during RSV infection. Acute respiratory tract disease was not associated with MMP-9 protein/protease activity. Additional studies using real-time quantitative PCR suggested that MMP-9 mRNA copy numbers were elevated in normal human bronchial epithelial (NHBE) cells infected with RSV, while TIMP-1 and TIMP-2 were not increased. However, ELISA did not reveal MMP-9 protein in the NHBE cell culture supernatants. Hence, the data implied that airway epithelial cells were not the primary source of MMP or TIMP following paramyxovirus infection. Taken together, the data suggested that paramyxovirus infection perturbs MMP-9/TIMP-1 homeostasis that in turn may contribute to the severity of respiratory tract disease.     

人转化生长因子β1基因重组腺病毒的构建与鉴定

背景：转化生长因子β1能促进多种细胞的生长增殖,是调控骨髓间充质干细胞向成骨方向定向分化的主要生长因子。 目的：利用AdMax系统构建人转化生长因子β1(hTGF-β1)基因的重组腺病毒表达载体。 方法：采用PCR方法克隆人转化生长因子β1基因cDNA后,插入线性化表达载体pAV-MCMV-EGFP-3FLAG中,转化E.coli DH5α感受态细胞,构建pAV-MCMV-hTGF-β1重组质粒。 结果与结论：含目的基因的重组腺病毒质粒共转染293细胞进行病毒包装、扩增后, 经PCR、Western Blot检测得到转化生长因子β1重组腺病毒,其滴度约为1.25×10¹⁰ pfu/mL。表明利用AdMax系统成功可构建人转化生长因子β1腺病毒载体,并可满足进一步的转化生长因子β1成骨作用的研究。     

Imbalance between matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in toluene diisocyanate-induced asthma

BACKGROUND: Toluene diisocyanate (TDI)-induced asthma is an inflammatory disease of the airways characterized by airway remodelling due, at least in part, to an excess of extracellular matrix deposition in the airway wall. The ratio of matrix metalloproteinase-9 (MMP-9) and its inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1) may be a marker of the balance between airway tissue destruction and repair. OBJECTIVE: We determined whether an imbalance of the MMP-9 : TIMP-1 molar ratio is present before and/or after challenge with TDI. METHODS: We used a murine model of TDI-induced asthma to evaluate the MMP-9 and TIMP-1 balance in the lung. RESULTS : The expression of MMP-9 and TIMP-1 mRNAs and proteins in the lungs increased at 7 h after TDI inhalation and continued for up to 72 h. Immunohistochemical and immunocytological analyses in the lungs of TDI-exposed mice revealed increases of immunoreactive MMP-9 and TIMP-1. There were significant correlations between the levels of MMP-9 or TIMP-1 and the number of neutrophils, lymphocytes, or eosinophils. The molar ratio of MMP-9/TIMP-1 significantly decreased at 7 h after TDI inhalation and continued up to 72 h. CONCLUSION: These data suggest that TDI-induced asthma may be associated with an imbalance between MMP-9 and TIMP-1, which could be useful as a marker of airway inflammation and airway remodelling in this disease.