Melloni B
Service de Pneumologie, Hôpital du Cluzeau, CHU Limoges (87).
Presse Med. 2002 Sep;31 Spec No 1:HS11-5.
PATHOPHYSIOLOGY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): Chronic inflammation of the upper airways, pulmonary parenchyma and pulmonary vasculature is the characteristic feature of COPD. Two mechanisms besides inflammation are also involved: oxidative stress and imbalance between proteinases and antiproteinases. Cellular infiltration of the upper airways involved neutrophils, macrophages, T lymphocytes and eosinophils. Inflammatory mediators appear to play a crucial role in the interaction between inflammation and obstruction. PROPERTIES OF FENSPIRIDE: A nonsteroidal drug, fenspiride, exhibits interesting properties documented in vitro: anti-bronchoconstriction activity, anti-secretory activity, and anti-inflammatory activity (reduction in the activity of phospholipase A2 and release of proinflammatory leukotriens). Two french clinical trials have studied the efficacy of fenspiride in patients with acute excerbation or stable COPD and have demonstrated an improvement in the group treated with fenspiride compared with the placebo group.
慢性阻塞性肺疾病(COPD)的病理生理学:上呼吸道、肺实质和肺血管的慢性炎症是COPD的特征性表现。除炎症外,还涉及两种机制:氧化应激以及蛋白酶和抗蛋白酶之间的失衡。上呼吸道的细胞浸润涉及中性粒细胞、巨噬细胞、T淋巴细胞和嗜酸性粒细胞。炎症介质似乎在炎症与阻塞的相互作用中起关键作用。 非那吡啶的特性:非那吡啶是一种非甾体类药物,在体外显示出有趣的特性:抗支气管收缩活性、抗分泌活性和抗炎活性(降低磷脂酶A2的活性以及促炎白三烯的释放)。两项法国临床试验研究了非那吡啶在急性加重期或稳定期COPD患者中的疗效,结果表明与安慰剂组相比,非那吡啶治疗组的病情有所改善。