Brusasco Vito, Pellegrino Riccardo
Dipartimento di Medicina Interna, Università di Genova, 16132 Genova, Italy.
J Appl Physiol (1985). 2003 Sep;95(3):1305-13. doi: 10.1152/japplphysiol.00001.2003.
In vivo, the airway response to constrictor stimuli is the net result of a complex array of factors, some facilitating and some opposing airway narrowing, which makes the interpretation of bronchial challenges far from being straightforward. This review begins with a short description of the complex mechanisms of airway smooth muscle activation and force generation as the starting events for airway narrowing. It then focuses on gain factors modulating airway smooth muscle shortening and on the geometric factors determining the magnitude of reduction in airway caliber in vivo. Finally, in light of the evidence that mechanical modulation of airway smooth muscle tone and airway narrowing is at least as important as the inflammatory contractile mediators in the pathogenesis of airway hyper-responsiveness, the implications for the interpretation of bronchial challenges in clinical settings are discussed.
在体内，气道对收缩刺激的反应是一系列复杂因素的综合结果，其中一些因素促进气道狭窄，而另一些则起相反作用，这使得对支气管激发试验的解读绝非易事。本综述首先简要描述气道平滑肌激活和力量产生的复杂机制，这些是气道狭窄的起始事件。然后重点关注调节气道平滑肌缩短的增益因素以及决定体内气道管径缩小程度的几何因素。最后，鉴于有证据表明气道平滑肌张力和气道狭窄的机械调节在气道高反应性发病机制中至少与炎症性收缩介质同样重要，本文讨论了其在临床环境中对支气管激发试验解读的意义。
