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[哮喘气道炎症分析:临床学术兴趣]

[Analysis of airway inflammation in asthma: clinical academic interest].

作者信息

Louis R

机构信息

Service de Pneumologie, CHU Liège, GIGA13 Research Unit.

出版信息

Bull Mem Acad R Med Belg. 2011;166(7-9):273-8; discussion 279.

Abstract

While the importance of airway inflammation in severe asthma was known from the pathologists for more than one century, the demonstration of an airway inflammatory process in mild asthma dates back to the early nineties. With the advent of bronchoscopy making it possible to sample biopsies and bronchoalveolar lavage, it has become clear that mild to moderate asthma was characterized by a Th2 driven airway eosinophilic inflammation where cytokine like IL-4, IL-5 and IL-13 play a critical role. Soon after, were developed the technique of induced sputum and the measurement of exhaled nitric oxide as non invasive tools to assess airway inflammation. The application of these techniques on large samples of subjects has been instrumental to the development of the concept of inflammatory phenotype in asthma which proved to be pertinent in the drug management of the disease. Therefore, within a 20 year laps, the monitoring of airway inflammation, also called inflammometry, has gone beyond the academic world to become crucial for the appropriate management of asthmatics by the clinician.

摘要

虽然气道炎症在重度哮喘中的重要性在一个多世纪前就已被病理学家所熟知,但轻度哮喘中气道炎症过程的证明可追溯到90年代初。随着支气管镜检查的出现,使得获取活检样本和进行支气管肺泡灌洗成为可能,人们清楚地认识到,轻至中度哮喘的特征是由Th2驱动的气道嗜酸性粒细胞炎症,其中细胞因子如IL-4、IL-5和IL-13起着关键作用。此后不久,诱导痰技术和呼出一氧化氮测量技术作为评估气道炎症的非侵入性工具得到了发展。这些技术在大量受试者样本上的应用有助于哮喘炎症表型概念的发展,事实证明这一概念在该疾病的药物管理中具有相关性。因此,在20年的时间里,气道炎症监测,也称为炎症测量,已从学术界走向临床,成为临床医生对哮喘患者进行适当管理的关键。

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