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过敏性哮喘的治疗:调节 Th2 细胞及其反应。

Treatment of allergic asthma: modulation of Th2 cells and their responses.

机构信息

Department of Dermatology, DIAID, Experimental Allergy Laboratory, Medical University of Vienna, Vienna, Austria.

出版信息

Respir Res. 2011 Aug 25;12(1):114. doi: 10.1186/1465-9921-12-114.


DOI:10.1186/1465-9921-12-114
PMID:21867534
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3179723/
Abstract

Atopic asthma is a chronic inflammatory pulmonary disease characterised by recurrent episodes of wheezy, laboured breathing with an underlying Th2 cell-mediated inflammatory response in the airways. It is currently treated and, more or less, controlled depending on severity, with bronchodilators e.g. long-acting beta agonists and long-acting muscarinic antagonists or anti-inflammatory drugs such as corticosteroids (inhaled or oral), leukotriene modifiers, theophyline and anti-IgE therapy. Unfortunately, none of these treatments are curative and some asthmatic patients do not respond to intense anti-inflammatory therapies. Additionally, the use of long-term oral steroids has many undesired side effects. For this reason, novel and more effective drugs are needed. In this review, we focus on the CD4+ Th2 cells and their products as targets for the development of new drugs to add to the current armamentarium as adjuncts or as potential stand-alone treatments for allergic asthma. We argue that in early disease, the reduction or elimination of allergen-specific Th2 cells will reduce the consequences of repeated allergic inflammatory responses such as lung remodelling without causing generalised immunosuppression.

摘要

特应性哮喘是一种慢性炎症性肺部疾病,其特征是反复出现喘息、呼吸困难,气道内存在 Th2 细胞介导的炎症反应。目前,根据严重程度,通过支气管扩张剂(如长效β激动剂和长效抗胆碱能拮抗剂)或抗炎药物(如皮质类固醇[吸入或口服]、白三烯调节剂、茶碱和抗 IgE 治疗)进行治疗和控制。不幸的是,这些治疗方法都没有治愈作用,一些哮喘患者对强化抗炎治疗没有反应。此外,长期口服类固醇的使用有许多不良副作用。因此,需要新型和更有效的药物。在这篇综述中,我们重点关注 CD4+Th2 细胞及其产物,作为开发新药的靶点,以增加当前的治疗手段,作为过敏性哮喘的辅助治疗或潜在的独立治疗方法。我们认为,在疾病早期,减少或消除过敏原特异性 Th2 细胞将减少反复过敏炎症反应(如肺重塑)的后果,而不会引起全身性免疫抑制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a25/3179723/0cdfa634ad39/1465-9921-12-114-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a25/3179723/94a5b1c6dffe/1465-9921-12-114-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a25/3179723/0cdfa634ad39/1465-9921-12-114-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a25/3179723/94a5b1c6dffe/1465-9921-12-114-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a25/3179723/0cdfa634ad39/1465-9921-12-114-2.jpg

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本文引用的文献

[1]
Are TIM proteins involved in asthma development or pathology?

Clin Exp Allergy. 2011-7

[2]
Silencing IL-23 expression by a small hairpin RNA protects against asthma in mice.

Exp Mol Med. 2011-4-30

[3]
Safety profile and clinical activity of multiple subcutaneous doses of MEDI-528, a humanized anti-interleukin-9 monoclonal antibody, in two randomized phase 2a studies in subjects with asthma.

BMC Pulm Med. 2011-2-28

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PLoS One. 2011-1-28

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Am J Respir Crit Care Med. 2011-2-4

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J Exp Med. 2010-9-6

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