Gazzola M, Flamand N, Bossé Y
Université Laval, Québec, Canada.
Université Laval, Québec, Canada.
Rev Mal Respir. 2020 Jun;37(6):462-473. doi: 10.1016/j.rmr.2020.03.009. Epub 2020 May 30.
A significant portion of symptoms in some lung diseases results from an excessive constriction of airways due to the contraction of smooth muscle and bronchial hyperresponsiveness. A better understanding of the extracellular molecules that control smooth muscle contractility is necessary to identify the underlying causes of the problem.
Almost a hundred molecules, some of which newly identified, influence the contractility of airway smooth muscle. While some molecules activate the contraction, others activate the relaxation, thus acting directly as bronchoconstrictors and bronchodilators, respectively. Other molecules do not affect contraction directly but rather influence it indirectly by modifying the effect of bronchoconstrictors and bronchodilators. These are called bronchomodulators. Some of these bronchomodulators increase the contractile effect of bronchoconstrictors and could thus contribute to bronchial hyperresponsiveness.
Considering the high number of molecules potentially involved, as well as the level of functional overlap between some of them, identifying the extracellular molecules responsible for excessive airway constriction in a patient is a major contemporary challenge.
在某些肺部疾病中,相当一部分症状是由于平滑肌收缩和支气管高反应性导致气道过度收缩引起的。为了确定问题的根本原因,有必要更好地了解控制平滑肌收缩性的细胞外分子。
近百种分子(其中一些是新发现的)影响气道平滑肌的收缩性。一些分子激活收缩,另一些分子激活舒张,因此分别直接作为支气管收缩剂和支气管扩张剂起作用。其他分子不直接影响收缩,而是通过改变支气管收缩剂和支气管扩张剂的作用间接影响收缩。这些被称为支气管调节因子。其中一些支气管调节因子会增加支气管收缩剂的收缩作用,从而可能导致支气管高反应性。
考虑到潜在涉及的分子数量众多,以及其中一些分子之间的功能重叠程度,确定导致患者气道过度收缩的细胞外分子是当代的一项重大挑战。