Slapke J
Forschungsinstitut für Lungenkrankheiten und Tuberkulose Berlin-Buch/DDR.
Z Erkr Atmungsorgane. 1988;171(1):40-4.
A decreased threshold of bronchial contractility under the influence of nonspecific and specific factors (bronchial hyperreactivity--BHR) is a disposing factor and precondition to the development of asthmatic disease. Probably the disturbance of the barrier function of the bronchial epithelium plays a central role in bronchial hyperreactivity. The release of phospholipid mediators from membrane phospholipids might be decisive for the establishment of bronchial hyperreactivity. This is documented, before all, by the decreasing effect of glucocorticosteroids upon the hyperreactivity since their pharmacologic efficacy is realized in first line by an inhibition of the release of arachidonic acid. We are arguing that an endogenously not compensated basical release of arachidonic acid and platelet activating factor is causally related to bronchial hyperreactivity. Prevention of asthma as well as therapy must aim at systematic reduction of bronchial hyperreactivity. Beside glucocorticosteroids and other inhibitors of phospholipase could prospectively be of therapeutic interest inhibitors of synthesis or antagonists of 5-lipoxygenase, of platelet activating factor, of leukotrienes or thromboxanes. There exist theoretical bases for practical measures of directed prevention of asthma in persons at risk. Their efficiency still awaits scientific evaluation.
在非特异性和特异性因素影响下支气管收缩性阈值降低（支气管高反应性——BHR）是哮喘病发生的易感因素和前提条件。支气管上皮屏障功能的紊乱可能在支气管高反应性中起核心作用。膜磷脂中磷脂介质的释放可能对支气管高反应性的形成起决定性作用。首先，这一点可由糖皮质激素对高反应性的降低作用得到证明，因为它们的药理作用首先是通过抑制花生四烯酸的释放来实现的。我们认为，内源性未得到代偿的花生四烯酸和血小板活化因子的基础释放与支气管高反应性存在因果关系。哮喘的预防和治疗都必须旨在系统性降低支气管高反应性。除了糖皮质激素外，其他磷脂酶抑制剂，如5-脂氧合酶、血小板活化因子、白三烯或血栓素的合成抑制剂或拮抗剂，可能在未来具有治疗意义。对于有风险人群进行针对性哮喘预防的实际措施存在理论基础。其有效性仍有待科学评估。
