Simpson Jodie L, Brooks Collin, Douwes Jeroen
NHMRC Centre for Respiratory and Sleep Medicine, The University of Newcastle, Newcastle, Australia.
Paediatr Respir Rev. 2008 Dec;9(4):263-70. doi: 10.1016/j.prrv.2008.05.007. Epub 2008 Oct 15.
Asthma is a complex disorder and evidence now suggests that it is not solely attributable either to allergy or eosinophilia. Non-eosinophilic asthma accounts for up to one half of all cases and a large proportion have a non-allergic aetiology. The innate immune system responds to a variety of triggers, including viral and bacterial components which are known non-allergic triggers of asthma. The innate immune response may be involved in both the development of and protection against asthma. Factors which are likely to determine the nature of the response include the timing of the exposure (childhood or adulthood), baseline asthma inflammatory subtype (eosinophilic or non-eosinophilic) and the dose of the exposure. Gene-environment interactions are likely to modify the response. Further research is required to elucidate the specific mechanisms involved in the innate immune response in asthma and will be important in the identification of new targets for therapy and management.
哮喘是一种复杂的疾病，目前有证据表明，它并非完全由过敏或嗜酸性粒细胞增多引起。非嗜酸性粒细胞性哮喘占所有病例的一半，且很大一部分病例有非过敏性病因。先天性免疫系统对多种触发因素产生反应，包括病毒和细菌成分，这些都是已知的哮喘非过敏性触发因素。先天性免疫反应可能参与哮喘的发生发展及预防。可能决定反应性质的因素包括接触时间（儿童期或成年期）、基线哮喘炎症亚型（嗜酸性粒细胞性或非嗜酸性粒细胞性）以及接触剂量。基因-环境相互作用可能会改变反应。需要进一步研究以阐明哮喘先天性免疫反应中涉及的具体机制，这对于确定新的治疗和管理靶点至关重要。
