Vaillant P, Martinet Y
Service de pneumologie, CHRU de Nancy et INSERM Unité 14.
Rev Prat. 1991 May 11;41(14):1247-52.
Fibrosis is a condition where the functional tissue of an organ has been replaced by mesenchymal cells and their extracellular matrix. The process is frequent and may be regarded as univocal and independent of aetiology. An initial tissue damage is responsible for an inflammatory reaction which modulates and controls tissue repair with accumulation of mesenchymal cells, an accumulation which results from their migration and replication under the influence of chemotactic and/or mitogenic mediators (cytokines). Fibrosis occurs as an accentuation of this physiological process and may be understood as a healing process that has succeeded beyond normal expectation. Studies of idiopathic pulmonary fibrosis have improved our understanding of the physiopathology of pulmonary fibrosis. Alveolitis sets in response to an initial injury of undetermined nature, and from then on lymphocytes, neutrophils and macrophages intervene in the pathological process: (1) lymphocytes contribute to the perpetuation of the process by local production of immune complexes and coactivation of other inflammatory cells; (2) neutrophils and, to a lesser extent, eosinophils worsen the initial tissue injury by producing proteases and oxydants; (3) finally, macrophages control the local accumulation of mesenchymal cells by producing chemotactic and growth factors and by modulating the secretion by these cells of extracellular matrix.
纤维化是一种器官的功能组织被间充质细胞及其细胞外基质所取代的病症。该过程很常见，可被视为单一且与病因无关的。初始组织损伤引发炎症反应，该反应调节并控制组织修复，同时伴有间充质细胞的积累，这种积累是它们在趋化性和/或促有丝分裂介质（细胞因子）影响下迁移和复制的结果。纤维化是这一生理过程的强化，可被理解为一个超出正常预期而成功的愈合过程。对特发性肺纤维化的研究增进了我们对肺纤维化病理生理学的理解。肺泡炎是对性质未明的初始损伤的反应，从那时起淋巴细胞、中性粒细胞和巨噬细胞便介入病理过程：（1）淋巴细胞通过局部产生免疫复合物和共同激活其他炎症细胞而促使该过程持续；（2）中性粒细胞以及程度较轻的嗜酸性粒细胞通过产生蛋白酶和氧化剂而加重初始组织损伤；（3）最后，巨噬细胞通过产生趋化因子和生长因子以及调节这些细胞分泌细胞外基质来控制间充质细胞的局部积累。
