Lapp N L
W V Med J. 1992 Oct;88(10):457-9.
In the 1950s, asthma was defined in terms of reversible airflow obstruction; and then during the 1980s, the emphasis on the diagnosis and treatment of asthma centered on airway hyperreactivity. Recent advances in molecular biology and immunopathology have focused diagnosis and treatment of asthma on inflammatory mechanisms. This article briefly reviews some of the inflammatory components of asthma and the rationale for using inhaled (topical) anti-inflammatory agents in treatment. It also calls attention to some potential and actual adverse effects of inhaled corticosteroids. It mentions some agents used as alternate therapy for "steroid resistant" patients. The alteration of airway immunopathology of asthmatics before and after use of inhaled corticosteroids is described. There is evidence that treatment directed solely towards airway inflammation without use of inhaled B-agonist agents does not eliminate airway hyperresponsiveness.
在20世纪50年代，哮喘是根据可逆性气流阻塞来定义的；然后在20世纪80年代，哮喘的诊断和治疗重点集中在气道高反应性上。分子生物学和免疫病理学的最新进展使哮喘的诊断和治疗聚焦于炎症机制。本文简要回顾了哮喘的一些炎症成分以及使用吸入（局部）抗炎药物进行治疗的基本原理。它还提请注意吸入性皮质类固醇的一些潜在和实际的不良反应。文中提到了一些用作“类固醇抵抗”患者替代疗法的药物。描述了哮喘患者使用吸入性皮质类固醇前后气道免疫病理学的改变。有证据表明，仅针对气道炎症而不使用吸入性β-激动剂的治疗并不能消除气道高反应性。
