Department of Respiratory Medicine, Changhai Hospital, The Second Military Medical University, 168 Changhai Road, Yangpu District, Shanghai 200433, China.
Med Hypotheses. 2009 Dec;73(6):1065-6. doi: 10.1016/j.mehy.2009.04.037. Epub 2009 Oct 12.
Tuberculous tracheobronchial stenosis is a serious clinical problem because it can cause obstructive pneumonia, dyspnea on exertion even pulmonary atelectasis of the whole lung. More than 90% of the patients with EBTB have some degree of bronchial stenosis. The interventional therapy through bronchoscopy has been used as standard treatment to deal with the scar stenosis of EBTB routinely, which have showed significant effects to keep airway open. However the scar rapid growing and restenosis can often be seen in many patients. TGF-beta1 has been demonstrated to play a very important role in scar formation. Some agents against TGF-beta1 have been proved to inhibit the scar growing effectively. The level of TGF-beta elevated in the BALF of EBTB patients suggests TGF-beta be related to the pathogenesis of stenosis induced by EBTB. We hypothesize that inhalation of TGF-beta1 antibody can neutralize the local TGF-beta and reduce the level of this kind of cytokine so as to prevent the scar formation partially, and find a new pathway to deal with this tough clinical problem.
结核性气管支气管狭窄是一个严重的临床问题，因为它可导致阻塞性肺炎、劳力性呼吸困难，甚至全肺不张。超过 90%的 EBTB 患者存在不同程度的支气管狭窄。经支气管镜介入治疗已作为常规治疗方法来处理 EBTB 的瘢痕狭窄，对保持气道通畅具有显著效果。然而，许多患者常出现瘢痕快速生长和再狭窄。TGF-β1 已被证明在瘢痕形成中起非常重要的作用。一些针对 TGF-β1 的药物已被证明能有效抑制瘢痕生长。EBTB 患者 BALF 中 TGF-β 水平升高提示 TGF-β 与 EBTB 引起的狭窄发病机制有关。我们假设吸入 TGF-β1 抗体可以中和局部 TGF-β，降低这种细胞因子的水平，从而部分预防瘢痕形成，并为处理这一棘手的临床问题找到新途径。
