1 Department of Medicine, University College Dublin, Dublin, Ireland; and.
2 Division of Pulmonary and Critical Care Medicine, Department of Medicine, and.
Ann Am Thorac Soc. 2018 Nov;15(Suppl 3):S184-S191. doi: 10.1513/AnnalsATS.201807-485AW.
Autopsy studies in fatal asthma have clearly documented the central role of airway plugging with pathologic mucus in the pathophysiology of death from asthma, but the role of mucus plugs in chronic severe asthma has been less well understood. Recently, multidetector computerized tomography imaging of the lungs has emerged as a valuable method to visualize mucus plugs in asthma. These multidetector computerized tomography data have revealed mucus plugs as a common occurrence in severe forms of asthma. In addition, an image-based mucus plug scoring system shows that mucus plugs are strongly associated with measures of airflow obstruction and with biomarkers of type 2 cytokine and eosinophilic inflammation. These data provide a rationale for treating airflow obstruction in severe asthma with mucolytics, and they also raise the possibility that treatments that target type 2 inflammation may decrease mucus plugs in asthma.
在致命性哮喘的尸检研究中，气道中病理性黏液栓的形成在哮喘致死的病理生理学中起着核心作用，这一点已得到明确证实，但是黏液栓在慢性重度哮喘中的作用却还不太清楚。最近，肺部多层螺旋 CT 成像已成为一种可视化哮喘黏液栓的有用方法。这些多层螺旋 CT 数据显示，黏液栓在重度哮喘中很常见。此外，基于图像的黏液栓评分系统显示，黏液栓与气流阻塞的测量指标以及 2 型细胞因子和嗜酸性粒细胞炎症的生物标志物密切相关。这些数据为使用黏液溶解剂治疗重度哮喘的气流阻塞提供了依据，同时也提示针对 2 型炎症的治疗可能会减少哮喘中的黏液栓。
