Wilson John W, Robertson Colin F
Department of Respiratory Medicine and Monash Medical School, The Alfred Hospital, Prahran 3181, Australia.
Paediatr Respir Rev. 2002 Sep;3(3):219-29. doi: 10.1016/s1526-0542(02)00200-2.
A number of characteristic changes occur in the bronchial wall in paediatric airway diseases. The process of remodelling is usually associated with specific changes to the vasculature, resulting in an increase in vessel numbers, vasodilatation, vessel leakage and cellular margination with transmigration to target tissues. This combined action in conditions such as asthma, cystic fibrosis and bronchiolitis lead to airway wall thickening and reduced airflow. Each component of the vascular response has been shown to be controlled by a range of inflammatory mediators and growth factors. These factors are regulated by a complex process involving gene expression, transcription and translation at the molecular level, protein release, binding to matrix elements and receptors on endothelial cells, then the endothelial response itself. A number of commonly used airway medications are potentially capable of modulating the vascular response to inflammatory stimuli. New therapies may be able to improve airflow through better regulation of vessel growth, dilatation and leakage in the airway wall.
在儿科气道疾病中，支气管壁会出现一些特征性变化。重塑过程通常与脉管系统的特定变化相关，导致血管数量增加、血管扩张、血管渗漏以及细胞边缘化并迁移至靶组织。在哮喘、囊性纤维化和细支气管炎等病症中，这种联合作用会导致气道壁增厚和气流减少。血管反应的每个组成部分都已被证明受一系列炎症介质和生长因子的控制。这些因子通过一个复杂的过程进行调节，该过程涉及分子水平的基因表达、转录和翻译、蛋白质释放、与基质成分及内皮细胞上受体的结合，然后是内皮细胞自身的反应。许多常用的气道药物有可能调节血管对炎症刺激的反应。新的疗法或许能够通过更好地调节气道壁血管的生长、扩张和渗漏来改善气流。
