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[囊性纤维化中的早期支气管炎症]

[Early bronchial inflammation in cystic fibrosis].

作者信息

Puchelle Edith

机构信息

INSERM Unité 514, IFR 53, Hôpital Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims, France.

出版信息

J Soc Biol. 2002;196(1):29-35.

Abstract

Cystic fibrosis (CF) is the most common genetic autosomal recessive disease in caucasian north-american and european populations. The CF gene codes for a transmembrane glycoprotein called CFTR (Cystic Fibrosis Transmembrane Conductance Regulator), a chloride channel which regulates the luminal secretion of chloride and the active ion and water transport in the airway epithelial cells. Mutations of the CF gene lead to a dysregulation of chloride and sodium channel associated to airway mucus dehydration, neutrophil-dominated airway inflammation and chronic infection responsible for the morbidity and mortality of CF patients. Although a high number of studies has been devoted to the CFTR pleiotropic functions, the chronology of the physiopathological events leading to the airway inflammation linked to mutations of the CF gene is still an open question. The issue of whether airway inflammation takes place before infection or is a consequence of infection during CF pathogenesis is still controversial. It has been recently reported that in broncho-alveolar lavages collected in CF infants, there is an increased level of interleukin IL-8 and abnormal low level of IL-10. The decreased IL-10 production has been confirmed in peripheral blood monocytes as well as in airway cell lines. Under basal conditions, the increased expression of the pro-inflammatory IL-8 cytokine has also been recently observed in the airway liquid secreted by CF naïve humanized airway xenografts and in the supernatant culture of CF human airway epithelial cells. These results suggest that CFTR dysfunction may result in a constitutive pro-inflammatory vs anti-inflammatory imbalance in CF disease. Recent data from the literature suggest that the failure of chloride transport, the maturation defect and mistraffricking of mutated CFTR, lead to its accumulation in the endoplasmic reticulum and activation of NF-kappa B, responsible for the imbalance in the CF airway cell cytokine production.

摘要

囊性纤维化(CF)是北美白种人和欧洲人群中最常见的常染色体隐性遗传病。CF基因编码一种名为CFTR(囊性纤维化跨膜传导调节因子)的跨膜糖蛋白,它是一种氯离子通道,可调节氯离子的管腔分泌以及气道上皮细胞中离子和水的主动转运。CF基因的突变导致与气道黏液脱水、中性粒细胞为主的气道炎症以及导致CF患者发病和死亡的慢性感染相关的氯离子和钠离子通道失调。尽管大量研究致力于CFTR的多效性功能,但导致与CF基因突变相关的气道炎症的生理病理事件的时间顺序仍是一个悬而未决的问题。在CF发病机制中,气道炎症是在感染之前发生还是感染的结果这一问题仍存在争议。最近有报道称,在CF婴儿的支气管肺泡灌洗物中,白细胞介素IL-8水平升高而IL-10水平异常降低。外周血单核细胞以及气道细胞系中IL-10产生减少已得到证实。在基础条件下,最近在未接触过CF的人源化气道异种移植分泌的气道液体以及CF人气道上皮细胞的上清培养物中也观察到促炎细胞因子IL-8的表达增加。这些结果表明,CFTR功能障碍可能导致CF疾病中促炎与抗炎的组成性失衡。文献中的最新数据表明,氯离子转运失败、突变的CFTR的成熟缺陷和错误转运,导致其在内质网中积累并激活NF-κB,从而导致CF气道细胞细胞因子产生失衡。

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