Instituto de Agrobiotecnología, CSIC-Universidad Pública de Navarra-Gobierno de Navarra, 31192 Mutilva, Navarra, Spain.
Eur Respir J. 2012 Feb;39(2):467-77. doi: 10.1183/09031936.00061911. Epub 2011 Jul 7.
The human respiratory tract of individuals with normal lung function maintains a fine-tuned balance, being asymptomatically colonised by the normal microbiota in the upper airways and sterile in the lower tract. This equilibrium may be disrupted by the exposure to insults such as cigarette smoke. In the respiratory tract, the complex and noxious nature of inhaled cigarette smoke alters host-microorganism interaction dynamics at all anatomical levels, causing infections in many cases. Moreover, continuous exposure to cigarette smoke itself causes deleterious effects on the host that can trigger the development of chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and lung cancer. COPD is an irreversible airflow obstruction associated with emphysema, fibrosis, mucus hypersecretion and persistent colonisation of the lower airways by opportunistic pathogens. COPD patients keep a stable (without exacerbation) but progressively worsening condition and suffer periodic exacerbations caused, in most cases, by infections. Although smoking and smoking-associated diseases are associated with a high risk of infection, most therapies aim to reduce inflammatory parameters, but do not necessarily take into account the presence of persistent colonisers. The effect of cigarette smoke on host-pathogen interaction dynamics in the respiratory tract, together with current and novel therapies, is discussed.
在肺功能正常的个体中，人体呼吸道保持着微妙的平衡，在上呼吸道中无症状地定植着正常微生物群，而下呼吸道则无菌。这种平衡可能会因暴露于香烟烟雾等刺激物而被打破。在呼吸道中，吸入的香烟烟雾的复杂和有害性质会改变宿主-微生物相互作用的动力学，在许多情况下导致感染。此外，持续暴露于香烟烟雾本身会对宿主造成有害影响，从而引发慢性呼吸道疾病，如慢性阻塞性肺疾病（COPD）和肺癌。COPD 是一种不可逆的气流阻塞，与肺气肿、纤维化、黏液过度分泌以及下呼吸道机会性病原体的持续定植有关。COPD 患者的病情保持稳定（无恶化）但逐渐恶化，并周期性地恶化，在大多数情况下是由感染引起的。尽管吸烟和与吸烟相关的疾病与感染风险增加有关，但大多数治疗方法旨在降低炎症参数，但不一定考虑到持续定植的存在。本文讨论了香烟烟雾对呼吸道中宿主-病原体相互作用动力学的影响，以及当前和新型治疗方法。
