Department of Pathology and Laboratory Medicine, The James Hogg Research Centre/St. Paul's Hospital, University of British Columbia, 1081 Burrard Street, Rm. 166, Vancouver, BC V6Z 1Y6, Canada.
Pulm Pharmacol Ther. 2013 Feb;26(1):37-41. doi: 10.1016/j.pupt.2012.06.012. Epub 2012 Jul 6.
Reduced airway distensibility due to increased airway stiffness is a characteristic of asthma. Airway stiffness is determined by the property and structural organization of the various elements of the airway wall, and is often divided into active and passive components. Active stiffness is thought to be associated with activation of muscle cells in the airway wall. This component of stiffness can be inhibited when active force produced by the muscle is abolished. Passive stiffness, on the other hand, is thought to stem from non-muscle component of the airway wall, especially the collagen/elastin fibrous network of the extracellular matrix within which the muscle cells are embedded. In this brief review, the notion that passive stiffness is exclusively extracellular in origin is challenged. Recent evidence suggests that a substantial portion of the passive stiffness of an in vitro preparation of tracheal smooth muscle is calcium sensitive and is regulated by Rho-kinase, although the underlying mechanism and the details of regulation for the development of this intracellular passive stiffness are still largely unknown. To reduce airway stiffness different lines of attack must be tailored to different components of the stiffness. The regulatable passive stiffness is distinct from the relatively permanent stiffness of the extracellular matrix and the stiffness associated with active muscle contraction. To improve airway distensibility during asthma exacerbation, a comprehensive approach to reduce overall airway stiffness should therefore include a strategy for targeting the regulatable passive stiffness.
气道僵硬导致气道扩张能力降低是哮喘的一个特征。气道僵硬由气道壁各组成部分的特性和结构组织决定,通常分为主动和被动成分。主动僵硬被认为与气道壁肌肉细胞的激活有关。当肌肉产生的主动力被消除时,这个僵硬成分可以被抑制。另一方面,被动僵硬被认为源于气道壁的非肌肉成分,特别是嵌入其中的肌肉细胞的细胞外基质中的胶原/弹性纤维网络。在这篇简短的综述中,被动僵硬完全来源于细胞外的观点受到了挑战。最近的证据表明,体外培养的气管平滑肌的一部分被动僵硬具有钙敏感性,并受 Rho-激酶调节,尽管这种细胞内被动僵硬的潜在机制和调节细节在很大程度上仍不清楚。为了降低气道僵硬,必须针对僵硬的不同成分采取不同的治疗方法。可调节的被动僵硬与细胞外基质的相对永久性僵硬以及与主动肌肉收缩相关的僵硬不同。因此,为了在哮喘加重期间改善气道扩张能力,全面降低整体气道僵硬的方法应包括针对可调节的被动僵硬的策略。
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