Scadding Glenis Kathleen
RNTNE Hospital, London, UK.
Clin Respir J. 2015 Apr;9(2):153-6. doi: 10.1111/crj.12128. Epub 2014 Apr 15.
To explore asthma pathogenesis using data from upper and lower airways.
English-language papers on human asthma and nasal polyp subjects from 1990 onwards.
High-quality studies in established journals.
The recognition of its inflammatory nature led to a quantum leap in the understanding and treatment of asthma, with lives saved by inhaled corticosteroids. Further work at genetic, molecular, histological and clinical levels has shown that asthma is polymorphic and rarely involves isolated Th2 bronchial inflammation. Viral infections may act as an initiating event in children and adults, showing synergy with atopy. Chronic staphylococcal colonization of the mucosa may act as a promoter, as in atopic dermatitis. These two observations may be linked, with viruses providing an entry for bacteria into the mucosal epithelium.
Most asthma begins in the nose and involves allergy and infection: both viral and bacterial. The combination of atopy and infection suggests new possibilities for therapy.
利用来自上、下呼吸道的数据探索哮喘的发病机制。
1990年起有关人类哮喘和鼻息肉受试者的英文论文。
权威期刊上的高质量研究。
对哮喘炎症本质的认识使哮喘的理解和治疗取得了重大飞跃，吸入性糖皮质激素挽救了许多生命。在基因、分子、组织学和临床水平上的进一步研究表明，哮喘具有多态性，很少仅涉及孤立的Th2支气管炎症。病毒感染可能是儿童和成人哮喘的起始事件，与特应性表现出协同作用。黏膜的慢性葡萄球菌定植可能起到促进作用，如同在特应性皮炎中一样。这两个观察结果可能存在关联，病毒为细菌进入黏膜上皮提供了途径。
大多数哮喘始于鼻部，涉及过敏和感染：包括病毒感染和细菌感染。特应性和感染的结合为治疗提供了新的可能性。
