Chetta Alfredo, Marangio Emilio, Olivieri Dario
Department of Clinical Sciences, Section of Respiratory Diseases, University of Parma, Italy.
Acta Biomed. 2003 Dec;74(3):121-5.
Bronchial asthma is a chronic inflammatory disease characterized by inflammatory cell infiltration and by some long-lasting structural changes of bronchial wall, defined as airway remodelling. Airway remodelling can significantly affect two important functional characteristics of asthma, i.e. airway hyperresponsiveness and bronchial obstruction reversibility. Airway remodelling might be responsible for most of the inter-individual variability of bronchial hyperresponsiveness and might also determine the irreversible component of the airway obstruction, sometimes detectable in asthmatic patients. Among anti-asthma drugs, inhaled steroids are the most effective on inflammation and remodelling of airway wall. Recent evidences indicate that high doses of inhaled corticosteroids can significantly reduce not only inflammatory cells but also some components of airway remodelling, such as the increased airway wall vascularity and the basement membrane thickness. Conversely, low doses of inhaled corticosteroids can significantly act only on airway cell infiltration.
支气管哮喘是一种慢性炎症性疾病，其特征为炎症细胞浸润以及支气管壁的一些持久结构改变，即气道重塑。气道重塑可显著影响哮喘的两个重要功能特性，即气道高反应性和支气管阻塞可逆性。气道重塑可能是支气管高反应性个体间差异的主要原因，也可能决定气道阻塞的不可逆部分，这在哮喘患者中有时可检测到。在抗哮喘药物中，吸入性糖皮质激素对气道壁炎症和重塑最为有效。最近的证据表明，高剂量吸入性糖皮质激素不仅能显著减少炎症细胞，还能减少气道重塑的一些成分，如气道壁血管增多和基底膜厚度增加。相反，低剂量吸入性糖皮质激素仅能显著作用于气道细胞浸润。
