Pavia D, Lopez-Vidriero M T, Clarke S W
Department of Thoracic Medicine, Royal Free Hospital, London, England, UK.
Bull Eur Physiopathol Respir. 1987;23 Suppl 10:89s-94s.
Lung mucociliary clearance is significantly reduced in asthmatic patients compared to healthy controls even during clinical remission. Further retardation in mucous clearance occurs during sleep per se and this may be a contributing factor to nocturnal asthma. Chemical mediators of anaphylaxis appear to have various and, sometimes opposing effects on the two essential components for mucociliary clearance, namely cilia and mucus. Some mediators such as leukotrienes C4 and D4 are potent secretagogues and histamine increases the water flux into the lumen of the airways from the mucosa. Slow-reacting substance of anaphylaxis (SRS-A) reduces mucus transport whereas histamine enhances it. Ciliostimulation has been reported following allergen challenge and this contrasts with the cilioinhibitory effect of asthmatics' sputa. It appears however, that the net effect of the various chemicals of anaphylaxis is one of impairment of mucus clearance. Some pharmacological agents, used for the relief of bronchospasm and control of asthma, also stimulate mucociliary transport, a desirable additional effect.
与健康对照组相比，即使在临床缓解期，哮喘患者的肺黏液纤毛清除功能也显著降低。睡眠本身会进一步延缓黏液清除，这可能是夜间哮喘的一个促成因素。过敏反应的化学介质似乎对黏液纤毛清除的两个基本组成部分，即纤毛和黏液，有多种、有时甚至相反的作用。一些介质，如白三烯C4和D4是强效促分泌剂，组胺会增加从黏膜进入气道管腔的水流量。过敏反应慢反应物质（SRS - A）会减少黏液运输，而组胺则会增强它。据报道，过敏原激发后会出现纤毛刺激，这与哮喘患者痰液的纤毛抑制作用形成对比。然而，过敏反应的各种化学物质的净效应似乎是损害黏液清除。一些用于缓解支气管痉挛和控制哮喘的药物也会刺激黏液纤毛运输，这是一种理想的附加效果。
