Barnes P J
Am Rev Respir Dis. 1986 Dec;134(6):1289-314. doi: 10.1164/arrd.1986.134.5.1289.
Several aspects of airway function are under autonomic control: airway smooth muscle tone, submucosal gland secretion, epithelial cell function, bronchial vascular tone and permeability, and probably secretion from mast cells and other inflammatory cells. Neural control of human airways is more complex than previously recognized. In addition to afferent nerves and cholinergic adrenergic mechanisms (including circulating catecholamines), there are nonadrenergic, noncholinergic nerves that may be both excitatory and inhibitory. The neurotransmitters of this third nervous system are uncertain, but there is some evidence that neuropeptides may be involved. Several neuropeptides have recently been identified in human airways and, although they have potent effects, their pathophysiologic role is uncertain. There is much evidence that autonomic control of the airways may be abnormal in airway disease, particularly in asthma, but the precise role of neural mechanisms in the pathogenesis of air-flow obstruction and bronchial hyperresponsiveness remains to be defined.
气道平滑肌张力、黏膜下腺分泌、上皮细胞功能、支气管血管张力和通透性，可能还有肥大细胞及其他炎症细胞的分泌。人类气道的神经控制比之前认识到的更为复杂。除了传入神经和胆碱能、肾上腺素能机制（包括循环中的儿茶酚胺）外，还有非肾上腺素能、非胆碱能神经，它们可能具有兴奋性和抑制性。这个第三神经系统的神经递质尚不确定，但有一些证据表明神经肽可能参与其中。最近在人类气道中发现了几种神经肽，尽管它们具有强大的作用，但其病理生理作用尚不确定。有大量证据表明，气道疾病，尤其是哮喘，气道的自主神经控制可能异常，但神经机制在气流受限和支气管高反应性发病机制中的精确作用仍有待明确。
