Kardos Zsuzsanna
Országos Korányi TBC és Pulmonológiai Intézet, Budapest, Piheno út 1. - 1121.
Acta Pharm Hung. 2012;82(1):33-41.
Cigarette smoke-induced airway inflammation plays a central role in the pathophysiology of chronic obstructive pulmonary disease (COPD). It causes bronchial epithelial cell injury, which in turn initiates the recruitment of inflammatory cells and increases the production of cytokines, chemokines, proteases and other proinflammatory mediators followed by oxidative stress and protease/anti-protease imbalance impairing lung parenchymal elastic structures. Inhaled corticosteroids in combination with long-acting bronchodilators are generally recommended for the treatment of COPD. However, steroid responsiveness of patients with COPD is often poor, since oxidative stress may reduce the activity and expression of histone deacetylases, and therefore interfere with the anti-inflammatory action of corticosteroids. Recently, a number of studies has indicated that presence of sputum eosinophilia and/or elevated exhaled nitric oxide (NO) level may predict a better response to corticosteroid treatment in COPD patients. While sputum processing and its profiling is a time-consuming and technically demanding method, exhaled NO measurement is a simple and completely non-invasive tool, thus, the later could be more convenient for routine clinical use in the future.
香烟烟雾诱导的气道炎症在慢性阻塞性肺疾病（COPD）的病理生理学中起核心作用。它导致支气管上皮细胞损伤，进而引发炎症细胞的募集，并增加细胞因子、趋化因子、蛋白酶和其他促炎介质的产生，随后氧化应激和蛋白酶/抗蛋白酶失衡会损害肺实质弹性结构。吸入性糖皮质激素联合长效支气管扩张剂通常被推荐用于COPD的治疗。然而，COPD患者对类固醇的反应性往往较差，因为氧化应激可能会降低组蛋白脱乙酰酶的活性和表达，从而干扰糖皮质激素的抗炎作用。最近，一些研究表明，痰液嗜酸性粒细胞增多和/或呼出一氧化氮（NO）水平升高可能预示COPD患者对糖皮质激素治疗有更好的反应。虽然痰液处理及其分析是一种耗时且技术要求高的方法，但呼出NO测量是一种简单且完全无创的工具，因此，后者在未来的常规临床应用中可能更方便。
