Karamchand Sumanth, Williams Morne, Naidoo Poobalan, Decloedt Eric, Allwood Brian
Division of Pulmonology, Western Cape Department of Health, Tygerberg Hospital, Bellville, South Africa.
Department of Informatics, School of Health Professions, Rutgers University, New Jersey, USA.
J Thorac Dis. 2021 Feb;13(2):1230-1238. doi: 10.21037/jtd-20-1298.
Tuberculosis affects 10 million people and over 320,000 South Africans every year. A significant proportion of patients treated for tuberculosis develop post-tuberculous lung disease (PTBLD), a disease of chronic respiratory impairment for which there is a lack of affordable treatment options. PTBLD a heterogenous disorder that shares phenotypical features with chronic obstructive lung disease, bronchiectasis, lung fibrosis and destruction as well as pulmonary hypertension. There remains a paucity of proven pharmacotherapy for the management of PTBLD. Theophylline, a widely available and affordable medicine that has largely fell out of favour in high-income settings due to its toxicity and narrow therapeutic index, may be repositioned for the treatment of PTBLD. In this review, we unpack the potential role of theophylline in the management of PTBLD by reviewing the evidence for its bronchodilatory, anti-inflammatory and potential pleotrophic effects.
结核病每年影响着1000万人，其中南非患者超过32万。相当一部分接受结核病治疗的患者会患上结核后肺部疾病（PTBLD），这是一种慢性呼吸功能障碍疾病，目前缺乏经济实惠的治疗方案。PTBLD是一种异质性疾病，与慢性阻塞性肺疾病、支气管扩张、肺纤维化和破坏以及肺动脉高压具有相同的表型特征。目前仍缺乏经证实的用于治疗PTBLD的药物疗法。由于其毒性和治疗指数较窄，茶碱这种广泛可得且价格低廉的药物在高收入地区已基本失宠，但它可能被重新用于治疗PTBLD。在这篇综述中，我们通过回顾茶碱的支气管扩张、抗炎和潜在多效性作用的证据，来阐述其在PTBLD治疗中的潜在作用。
