Murphy Timothy F
Division of Infectious Diseases, University at Buffalo, State University of New York and Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA.
Curr Opin Infect Dis. 2006 Jun;19(3):225-30. doi: 10.1097/01.qco.0000224815.89363.15.
Bacteria cause approximately half of all chronic obstructive pulmonary disease exacerbations. The purpose of this review is to evaluate the status of research on the role of bacteria in airway inflammation during exacerbations and the mechanisms by which bacterial antigens induce inflammation.
Bacteria in the airways of adults with chronic obstructive pulmonary disease release antigens including endotoxin, peptidoglycan fragments, lipoproteins, and other molecules into the airways. These bacterial antigens induce potent inflammatory effects in the airways. Bacterial exacerbations are associated with systemic inflammation. Studies of Haemophilus influenzae, the most common bacterial cause of exacerbations, reveal that strains associated with exacerbations induce more inflammation compared to colonizing strains. H. influenzae antigens induce production of interleukin-8 and tumor necrosis factor-alpha, activate Toll-like 2 receptors, activate NFkappaB and p38 mitogen-activated protein signaling pathways, and have other inflammatory effects.
Research on the role of bacteria in causing inflammation in chronic obstructive pulmonary disease has been neglected for decades. Research should be directed at further evaluating the role of bacterial antigens in airway inflammation. Reducing or modulating bacterial infection of the airways in chronic obstructive pulmonary disease has the potential to reduce airway inflammation by eliminating an important inciting cause.
细菌导致约一半的慢性阻塞性肺疾病急性加重。本综述的目的是评估关于细菌在急性加重期间气道炎症中作用的研究现状以及细菌抗原诱导炎症的机制。
慢性阻塞性肺疾病成年患者气道中的细菌会将包括内毒素、肽聚糖片段、脂蛋白和其他分子在内的抗原释放到气道中。这些细菌抗原在气道中诱导强烈的炎症反应。细菌急性加重与全身炎症相关。对急性加重最常见的细菌病因——流感嗜血杆菌的研究表明，与定植菌株相比，与急性加重相关的菌株诱导的炎症更多。流感嗜血杆菌抗原可诱导白细胞介素-8和肿瘤坏死因子-α的产生，激活Toll样受体2，激活核因子κB和p38丝裂原活化蛋白信号通路，并具有其他炎症作用。
数十年来，细菌在慢性阻塞性肺疾病炎症发生中作用的研究一直被忽视。研究应致力于进一步评估细菌抗原在气道炎症中的作用。通过消除一个重要的激发因素，减少或调节慢性阻塞性肺疾病患者气道的细菌感染有可能减轻气道炎症。
