Maddox Lee, Schwartz David A
Pulmonary and Critical Care Division, Duke University Medical Center, Research Drive, Durham, North Carolina 27710; e-mail:
Annu Rev Med. 2002;53:477-98. doi: 10.1146/annurev.med.53.082901.103921.
Asthma is a chronic disorder of the airways that is characterized by reversible airflow obstruction and airway inflammation, persistent airway hyperreactivity, and airway remodeling. The etiology of asthma is complex and multifactorial. Recent advances have demonstrated the importance of genetics in the development of asthma, particularly atopic asthma. Environmental stimuli, particularly early childhood infections, have also been associated with the development of asthma. Most current data seem to suggest that these factors drive the development of a Th-2 lymphocyte-predominant immune response, which has been associated with atopy and IgE-mediated inflammation. The concept of reversible airflow obstruction has also recently been challenged. It is now clear that chronic airway changes occur, which may contribute to progressive airflow obstruction. We discuss the important influence of genetic and environmental factors on the emergence of the asthmatic phenotype. The significance of Th-1 and Th-2 lymphocyte-mediated immunity are discussed, and the inflammatory processes leading to chronic airway inflammation are detailed.
哮喘是一种气道慢性疾病，其特征为可逆性气流受限、气道炎症、持续性气道高反应性和气道重塑。哮喘的病因复杂且具有多因素性。最近的进展表明遗传学在哮喘，尤其是特应性哮喘的发病过程中具有重要作用。环境刺激因素，特别是儿童早期感染，也与哮喘的发病有关。目前大多数数据似乎表明，这些因素促使以Th-2淋巴细胞为主导的免疫反应的发生，而这种免疫反应与特应性和IgE介导的炎症相关。可逆性气流受限这一概念最近也受到了挑战。现在已经明确，慢性气道改变会出现，这可能导致进行性气流受限。我们讨论了遗传和环境因素对哮喘表型出现的重要影响。讨论了Th-1和Th-2淋巴细胞介导的免疫的意义，并详细阐述了导致慢性气道炎症的炎症过程。
