支气管哮喘气道重塑发生机制及其中西医防治现状
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摘要
支气管哮喘的发病机制复杂,目前尚未明确。现代研究已证实哮喘发病的重要病理改变是气道重塑,由气道炎症长期持续性的反复发作,反复修复造成上皮细胞的损伤及间充质转化、纤维化、增殖以及血管增生的一系列的改变。研究气道重塑对于哮喘意义重大,迫切需要研究气道重塑的机制及探索其防治策略。因此,该文就哮喘气道重塑的发生机制和中西医防治现状作一综述。
The pathogenesis of bronchial asthma is complex. Modern studies have confirmed that the important pathological changes of asthma are airway remodeling,which is caused by repeated repeated attacks of airway inflammation,repeated repair of epithelial cell damage and mesenchymal transformation,fibrosis,proliferation and vascular proliferation. The study of airway remodeling is of great significance to asthma. It is urgent to study the mechanism of airway remodeling and explore its prevention and treatment strategies. Therefore,this article reviews the mechanism of asthma airway remodeling and the current situation of prevention and treatment.
The pathogenesis of bronchial asthma is complex. Modern studies have confirmed that the important pathological changes of asthma are airway remodeling,which is caused by repeated repeated attacks of airway inflammation,repeated repair of epithelial cell damage and mesenchymal transformation,fibrosis,proliferation and vascular proliferation. The study of airway remodeling is of great significance to asthma. It is urgent to study the mechanism of airway remodeling and explore its prevention and treatment strategies. Therefore,this article reviews the mechanism of asthma airway remodeling and the current situation of prevention and treatment.
引文
[1]何安南.支气管哮喘气道重塑的研究进展[J].中国医药导报,2008,5(18):26-27.
[2]张伯礼,薛博瑜.中医内科学[M].北京:人民卫生出版社,2002:39-41.
[3]Seow CY,Schellenberg RR,Pare PD.Structural and functional changes in the airway smooth muscle of asthmatic subjects[J].Am J Respir Crit Care Med,1998,158(5):S179-S186.
[4]李中燕,王宋平.气道上皮细胞在支气管哮喘发病机制中的研究进展[J].实用医学杂志,2012,28(20):3485-3487.
[5]丁伟伟,童佳兵,马啸,等.支气管哮喘气道重塑的研究进展[J].临床肺科杂志,2014,19(12):2263-2265.
[6]Cohen L,E X,Tarsi J,et al.Epithelial cell proliferation contributes to airway remodeling in severe asthma[J].Am JRespir Crit Care Med,2007,176(2):138-145.
[7]潘亦林,朱燕亭,李满祥.支气管哮喘气道重塑的研究进展[J].中华肺部疾病杂志(电子版),2015,8(6):773-776.
[8]赵顺英.哮喘发病机制研究进展[J].实用儿科临床杂志,2003,18(10):768-771.
[9]杜彩霞,杜建新.哮喘气道重塑的相关细胞因子[J].青岛大学医学院学报,2012,48(6):555-560.
[10]刘斌,刘鑫,罗晓青,等.气道上皮细胞在哮喘中的作用[J].现代生物医学进展,2013,13(8):1583-1585.
[11]Zhang M,Zhang Z,Pan HY,et al.TGF-betal induces human bronchial epithelial cell to mesenchymal transition in vitro.Lung,2009,187:L187-L194.
[12]姬峰,李艳丽,郝俊清,等.FIZZ1诱导气道上皮间质转化导致哮喘早期气道重塑[J].山东大学学报(医学版),2010,48(2):80-84.
[13]Firszt R,Francisco D,Church TD,et al.Interlerleukin-13induces collagen type-1 expression through matrix metalloproteinase-2 and transforming growth factor-β1 in airway fibroblasts in asthma[J].Eur Respir J,2014,43(2):464-473.
[14]滕纪媛,尚莉丽.哮喘与气道重塑[J].临床肺科杂志,2010,15(1):74-75.
[15]叶新民,钟南山.基质金属蛋白酶与支气管哮喘气道重塑[J].中华哮喘杂志(电子版),2009,3(5):367-371.
[16]Higash Imotoy,Yamaga Y,Iwata T,et al.Increased serum concentration of Tisse inhihitormerallop in COPD patients[J].Eur Respir J,2005,25(5):8852-8901.
[17]陈奋华,陈壮桂,陈虹,等.哮喘患者气道网状基底膜厚度与气道壁重塑相关性探讨[J].中华医学杂志,2006,86(7):468-471.
[18]胡美,许欣婷,李红梅,等.Notch信号通路调控哮喘小鼠气道上皮下纤维化[J].中国病理生理杂志,2016,32(5):781-786.
[19]Bergeron C,Tulic MK,Hamid Q.Airway remodeling in asthma:from benchside to clinical practice[J].Can Respir J,2010,17(4):e85-e93.
[20]赵智丽,覃冬云.支气管哮喘气道重塑平滑肌增生机制[J].中华哮喘杂志(电子版),2011,5(6):442-445.
[21]高伟良,邱晨,曲敬来,等.哮喘气道重构时平滑肌细胞增殖周期的研究[J].中国医师杂志,2006,8(3):337-339.
[22]王丽玲,王秀杰.支气管哮喘患者诱导痰中血管内皮生长因子的研究[J].中国伤残医学,2010,18(6):21-22.
[23]Lee CG,Ma B,Takyar S,et al.Studies of vascular endothelial growth factor in asthma and chronic obstructive pulmonary disease[J].Proc Am Thorac Soc,2011,8(6):512-515.
[24]彭红娟,蔡绍曦,赵海金.血管内皮生长因子与支气管哮喘[J].实用医学杂志,2007,23(3):433-435.
[25]Kim SR,Lee KS,Park HS,et al.HIF-1αinhibition ameliorates an allergic airway disease via VEGF suppression in bronchial epithelium[J].Eur J Immunol,2010,40(10):2858-2869.
[26]李双,韩君萍,杨金华,等.针刺对支气管哮喘大鼠VEGF表达的影响[J].时珍国医国药,2016,27(12):3057-3058.
[27]邓鹏辉,黄传君,赵方正,等.TGF-β1、VEGF在哮喘小鼠的表达及细辛脑的干预作用[J].新医学,2018,49(1):25-29.
[28]沈华浩,杜旭菲,应颂敏.新版中国支气管哮喘防治指南与全球支气管哮喘防治创议的异同[J].中华结合和呼吸杂志,2018,41(3):166-168.
[29]郑海燕.支气管哮喘的病理机制及临床药物治疗[J].海峡药学,2011,23(2):87-92.
[30]郭敏,郭悦鹏.阿奇霉素对哮喘大鼠气道重塑的影响[J].新乡医学院学报,2013,30(5):364-367.
[31]陈宪海.支气管哮喘气道重塑的中医思考[J].山东中医杂志,2006,25(2):85-87.
[32]余建玮,薛汉荣,付向春.小青龙汤干预哮喘大鼠气道平滑肌细胞增殖作用的研究[J].四川中医,2011,29(10):23-25.
[33]张元元,陆党芝.支气管哮喘气道重塑的研究进展[J].大理学院学报,2006,5(8):59-62.
[34]张占锋,霍博雅.支气管哮喘气道重塑的中医药治疗现状[J].中国中医基础医学杂志,2010,16(11):1081-1083.
[35]何群.中西医结合治疗支气管哮喘的临床观察[J].中西医结合,2018,18:266-267.
[2]张伯礼,薛博瑜.中医内科学[M].北京:人民卫生出版社,2002:39-41.
[3]Seow CY,Schellenberg RR,Pare PD.Structural and functional changes in the airway smooth muscle of asthmatic subjects[J].Am J Respir Crit Care Med,1998,158(5):S179-S186.
[4]李中燕,王宋平.气道上皮细胞在支气管哮喘发病机制中的研究进展[J].实用医学杂志,2012,28(20):3485-3487.
[5]丁伟伟,童佳兵,马啸,等.支气管哮喘气道重塑的研究进展[J].临床肺科杂志,2014,19(12):2263-2265.
[6]Cohen L,E X,Tarsi J,et al.Epithelial cell proliferation contributes to airway remodeling in severe asthma[J].Am JRespir Crit Care Med,2007,176(2):138-145.
[7]潘亦林,朱燕亭,李满祥.支气管哮喘气道重塑的研究进展[J].中华肺部疾病杂志(电子版),2015,8(6):773-776.
[8]赵顺英.哮喘发病机制研究进展[J].实用儿科临床杂志,2003,18(10):768-771.
[9]杜彩霞,杜建新.哮喘气道重塑的相关细胞因子[J].青岛大学医学院学报,2012,48(6):555-560.
[10]刘斌,刘鑫,罗晓青,等.气道上皮细胞在哮喘中的作用[J].现代生物医学进展,2013,13(8):1583-1585.
[11]Zhang M,Zhang Z,Pan HY,et al.TGF-betal induces human bronchial epithelial cell to mesenchymal transition in vitro.Lung,2009,187:L187-L194.
[12]姬峰,李艳丽,郝俊清,等.FIZZ1诱导气道上皮间质转化导致哮喘早期气道重塑[J].山东大学学报(医学版),2010,48(2):80-84.
[13]Firszt R,Francisco D,Church TD,et al.Interlerleukin-13induces collagen type-1 expression through matrix metalloproteinase-2 and transforming growth factor-β1 in airway fibroblasts in asthma[J].Eur Respir J,2014,43(2):464-473.
[14]滕纪媛,尚莉丽.哮喘与气道重塑[J].临床肺科杂志,2010,15(1):74-75.
[15]叶新民,钟南山.基质金属蛋白酶与支气管哮喘气道重塑[J].中华哮喘杂志(电子版),2009,3(5):367-371.
[16]Higash Imotoy,Yamaga Y,Iwata T,et al.Increased serum concentration of Tisse inhihitormerallop in COPD patients[J].Eur Respir J,2005,25(5):8852-8901.
[17]陈奋华,陈壮桂,陈虹,等.哮喘患者气道网状基底膜厚度与气道壁重塑相关性探讨[J].中华医学杂志,2006,86(7):468-471.
[18]胡美,许欣婷,李红梅,等.Notch信号通路调控哮喘小鼠气道上皮下纤维化[J].中国病理生理杂志,2016,32(5):781-786.
[19]Bergeron C,Tulic MK,Hamid Q.Airway remodeling in asthma:from benchside to clinical practice[J].Can Respir J,2010,17(4):e85-e93.
[20]赵智丽,覃冬云.支气管哮喘气道重塑平滑肌增生机制[J].中华哮喘杂志(电子版),2011,5(6):442-445.
[21]高伟良,邱晨,曲敬来,等.哮喘气道重构时平滑肌细胞增殖周期的研究[J].中国医师杂志,2006,8(3):337-339.
[22]王丽玲,王秀杰.支气管哮喘患者诱导痰中血管内皮生长因子的研究[J].中国伤残医学,2010,18(6):21-22.
[23]Lee CG,Ma B,Takyar S,et al.Studies of vascular endothelial growth factor in asthma and chronic obstructive pulmonary disease[J].Proc Am Thorac Soc,2011,8(6):512-515.
[24]彭红娟,蔡绍曦,赵海金.血管内皮生长因子与支气管哮喘[J].实用医学杂志,2007,23(3):433-435.
[25]Kim SR,Lee KS,Park HS,et al.HIF-1αinhibition ameliorates an allergic airway disease via VEGF suppression in bronchial epithelium[J].Eur J Immunol,2010,40(10):2858-2869.
[26]李双,韩君萍,杨金华,等.针刺对支气管哮喘大鼠VEGF表达的影响[J].时珍国医国药,2016,27(12):3057-3058.
[27]邓鹏辉,黄传君,赵方正,等.TGF-β1、VEGF在哮喘小鼠的表达及细辛脑的干预作用[J].新医学,2018,49(1):25-29.
[28]沈华浩,杜旭菲,应颂敏.新版中国支气管哮喘防治指南与全球支气管哮喘防治创议的异同[J].中华结合和呼吸杂志,2018,41(3):166-168.
[29]郑海燕.支气管哮喘的病理机制及临床药物治疗[J].海峡药学,2011,23(2):87-92.
[30]郭敏,郭悦鹏.阿奇霉素对哮喘大鼠气道重塑的影响[J].新乡医学院学报,2013,30(5):364-367.
[31]陈宪海.支气管哮喘气道重塑的中医思考[J].山东中医杂志,2006,25(2):85-87.
[32]余建玮,薛汉荣,付向春.小青龙汤干预哮喘大鼠气道平滑肌细胞增殖作用的研究[J].四川中医,2011,29(10):23-25.
[33]张元元,陆党芝.支气管哮喘气道重塑的研究进展[J].大理学院学报,2006,5(8):59-62.
[34]张占锋,霍博雅.支气管哮喘气道重塑的中医药治疗现状[J].中国中医基础医学杂志,2010,16(11):1081-1083.
[35]何群.中西医结合治疗支气管哮喘的临床观察[J].中西医结合,2018,18:266-267.
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