Doherty Taylor, Broide David
Department of Medicine, University of California, San Diego, La Jolla, CA, USA.
Curr Opin Immunol. 2007 Dec;19(6):676-80. doi: 10.1016/j.coi.2007.07.017. Epub 2007 Aug 27.
Airway remodeling in asthma is defined by several structural changes including epithelial cell mucus metaplasia, an increase in peribronchial smooth muscle mass, subepithelial fibrosis, and angiogenesis. Cytokines, chemokines, and growth factors released from inflammatory and structural cells in the airway are considered to play a pivotal role in the development of remodeling. Studies of allergen induced airway remodeling in transgenic mice suggest an important role for TGF-beta, VEGF, Th2 cytokines (IL-5, IL-9, IL-13), and epithelial derived NF-kappaB regulated chemokines in airway remodeling. Although studies of bronchial biopsies from human asthmatics also demonstrate expression of TGF-beta, VEGF, IL-5, IL-9, IL-13, and NF-kappaB regulated chemokines, further human intervention studies are required in which individual cytokines or chemokines are neutralized to define their role in airway remodeling.
哮喘中的气道重塑由多种结构变化所定义，包括上皮细胞黏液化生、支气管周围平滑肌质量增加、上皮下纤维化和血管生成。气道中炎症细胞和结构细胞释放的细胞因子、趋化因子和生长因子被认为在重塑的发展中起关键作用。对转基因小鼠变应原诱导的气道重塑的研究表明，转化生长因子-β（TGF-β）、血管内皮生长因子（VEGF）、辅助性T细胞2型（Th2）细胞因子（白细胞介素-5（IL-5）、白细胞介素-9（IL-9）、白细胞介素-13（IL-13））以及上皮来源的核因子-κB（NF-κB）调节的趋化因子在气道重塑中起重要作用。尽管对人类哮喘患者支气管活检的研究也证实了TGF-β、VEGF、IL-5、IL-9、IL-13以及NF-κB调节的趋化因子的表达，但仍需要进一步的人体干预研究来中和单个细胞因子或趋化因子，以确定它们在气道重塑中的作用。
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