以树突状细胞为标靶的哮喘中西医认识及治疗手段

哮喘是以气道高反应及慢性气道炎症为特征的异质性疾病,最终可导致气道重塑等不可逆器质性损害。哮喘发病机制极为复杂,涉及多种炎性细胞、细胞因子、趋化因子和炎性反应递质等,并受环境因素和表观遗传因子调控。随着近年分子生物学和遗传学研究的不断深入,树突状细胞(DC)作为一类有众多表型及不同功能亚群的生物系统,被发现是参与哮喘发病的重要细胞,在启动哮喘免疫反应和维持免疫耐受方面发挥着关键作用。DC具有摄取、加工和提呈抗原,激活初始T淋巴细胞,介导免疫应答及免疫耐受等重要功能,直接影响着哮喘的发生发展。糖皮质激素至今仍被证实是预防哮喘发作的最有效药物,但其引发的不良反应备受关注;而中医药多靶点治疗哮喘的机制研究已引起越来越多国内外专家学者的重视,DC无疑是探索哮喘发病机制和探索安全有效的免疫疗法及研发天然中药产品的一个重要研究靶点。现从DC的研究概况、DC与哮喘发病的中西医认识及其相关性、主要研究工作等整理论述,以期为今后阐释中医药防治哮喘的作用机制及新药研发提供部分思路。

Discussion on the Pathogenesis and Treatment Progress of Traditional Chinese Medicine and Western Medicine on Asthma Targeting at Dendritic Cells

Asthma is a heterogeneous disease characterized by airway hyperreaction and chronic airway inflammation, which can eventually lead to airway remodeling and other irreversible organic damage.The pathogenesis of asthma is complex, involving a variety of inflammatory cells, cytokines, chemokines and inflammatory mediators, and is regulated by environmental factors and epigenetic factors.With the development of molecular biology and genetics in recent years, Dendritic cells (DC) are considered to be a biological system composed of a variety of phenotypic and functional subsets.It is an important cell involved in the pathogenesis of asthma, and plays a key role in initiating immune response and maintaining immune tolerance in asthma.Different phenotypes of DC have different functions such as uptake, processing and presentation antigens, activation of initial T lymphocytes, mediating immune response and immune tolerance, which directly affect the development of asthma.Glucocorticoids are still proven to be the most effective drugs for preventing asthma attacks, but their side effects attract much attention.Instead, more and more experts and scholars have paid more attention to the mechanism of multi target treatment of asthma by traditional Chinese medicine.DC is undoubtedly an important target for exploring the pathogenesis of asthma and exploring the safe and effective immunotherapy and the development of natural Chinese medicine products.In the paper, the general situation of DC, the understanding and correlation between DC and the pathogenesis of asthma between traditional Chinese medicine and Western medicine and the main research work are stated in order to provide some ideas for future interpretation of traditional Chinese medicine in the prevention and treatment of asthma mechanism and the research and development of new drugs.