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囊性纤维化跨膜电导调节因子:在慢性阻塞性肺疾病中的作用。

Cystic Fibrosis Transmembrane Conductance Regulator: Roles in Chronic Obstructive Pulmonary Disease.

机构信息

Division of Pulmonary, Allergy, and Critical Care and.

Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

出版信息

Am J Respir Crit Care Med. 2022 Mar 15;205(6):631-640. doi: 10.1164/rccm.202109-2064TR.

Abstract

Chronic obstructive pulmonary disease (COPD) manifests with a variety of clinical presentations, reflecting its complex pathology. Currently, care focuses on symptom amelioration and prevention of complications and thus is generally tailored to disease severity rather than targeting specific pathophysiologic mechanisms. Chronic inflammation and mucus hypersecretion are key features of COPD. Epithelial ion channel dysfunction may be important, as it results in airway dehydration and defective host defense, contributing to chronic airway inflammation. Recent evidence suggests considerable similarities between COPD and cystic fibrosis (CF), a disease in which chloride ion channel dysfunction has been extensively studied (in particular CFTR [CF transmembrane conductance regulator]). Understanding commonalities between CF and COPD, and the role of CFTR in CF, may help in designing strategies targeting ion channel dysfunction and lead to new treatments with potential to alter the natural history of disease progression. Here, we review the roles of airway mucus and CFTR in normal lung function, the previously underestimated contribution of mucus stasis to the development of COPD, and the evidence for targeting CFTR to counteract mucus accumulation.

摘要

慢性阻塞性肺疾病(COPD)表现出多种临床表现,反映了其复杂的病理生理学。目前,治疗重点在于缓解症状和预防并发症,因此通常根据疾病严重程度进行治疗,而不是针对特定的病理生理机制。慢性炎症和黏液过度分泌是 COPD 的主要特征。上皮离子通道功能障碍可能很重要,因为它会导致气道脱水和宿主防御功能缺陷,从而导致慢性气道炎症。最近的证据表明,COPD 与囊性纤维化(CF)之间存在很大的相似性,CF 是一种氯离子通道功能障碍已得到广泛研究的疾病(特别是 CFTR [囊性纤维化跨膜传导调节因子])。了解 CF 和 COPD 之间的共同点以及 CFTR 在 CF 中的作用,可能有助于设计针对离子通道功能障碍的策略,并带来可能改变疾病进展自然史的新治疗方法。在这里,我们回顾了气道黏液和 CFTR 在正常肺功能中的作用、以前被低估的黏液停滞对 COPD 发展的贡献,以及靶向 CFTR 以对抗黏液积聚的证据。

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