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气道高反应的发病机制目前仍然不清楚,但大多数人认同是气道的一种慢性炎症。近十年来,上皮缺陷学说逐渐成为解释气道高反应机制的主流观点。气道上皮不再被仅仅看作为单纯的机械屏障,而是机体内环境与外部环境相互作用的界面。气道上皮具有广泛的生理作用,包括抗氧化、内分泌和外分泌、黏液运输、生物代谢、结构性黏附、损伤修复、应激或炎症信号传递、抗原递呈作用等。借助这些生理作用,支气管上皮细胞在气道局部微环境稳态维持中发挥重要作用。有理由相信,气道上皮的结构完整性缺陷或功能紊乱是哮喘和慢性阻塞性肺疾病等气道高反应性疾病的启动环节。
The pathogenesis of airway hyperresponsiveness remains unclear, but most agree that it is a chronic inflammation of the airways. Over the past decade, the theory of epithelial defects has gradually become the mainstream point of view to explain the mechanism of airway hyperresponsiveness. Airway epithelium is no longer seen as merely a mere mechanical barrier, but an interface between the body's environment and the external environment. Airway epithelium has a wide range of physiological functions, including anti-oxidant, endocrine and exocrine, mucus transport, biological metabolism, structural adhesion, injury repair, stress or inflammatory signaling, antigen presentation and so on. With these physiological roles, bronchial epithelial cells play an important role in maintaining the homeostasis of airway local microenvironment. There is reason to believe that structural integrity defects or dysfunction of the airway epithelium are the starting point for airway hyperresponsiveness diseases such as asthma and chronic obstructive pulmonary disease.