Sato Yuki, Sugiyama Yoichiro, Ishida Tomoya, Inufusa Haruhiko, You Fukka, Joseph Davis, Hirano Shigeru
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan.
Division of Anti-Oxidant Research, Life Science Research Center, Gifu University, Yanagito 1-1, Gifu 501-1194, Japan.
Antioxidants (Basel). 2025 May 9;14(5):568. doi: 10.3390/antiox14050568.
Airway defensive reflexes, such as pharyngeal swallowing, coughing, and sneezing, play a pivotal role in maintaining airway homeostasis. These reflexes are controlled by complex mechanisms primarily governed by specific neuronal circuitry in the brainstem, referred to as central pattern generators. These behaviors also require optimal conditions for the peripheral organs within the airway and alimentary tracts, including the nose, pharynx, larynx, and trachea, which are vital for ensuring appropriate responsiveness and motor outputs. Oxidative stress is linked to the development and progress of impaired functions of those behaviors. Dysphagia caused by central or peripheral impairments, such as neurodegeneration of related neuronal networks and laryngeal desensitization, is likely associated with an increased level of oxidative stress. Chronic inflammation and allergic airway sensitization in the lower airways, including asthma, elevate oxidative stress levels and diminish the activity of antioxidant defense enzymes, which exacerbate the severity of respiratory conditions. Antioxidant supplements offer promising therapeutic benefits by facilitating the recovery of distorted airway defensive reflexes, although limited information has been provided concerning therapeutic strategies. Further studies are necessary to enhance our understanding of the pathophysiology of dysphagia and airway diseases related to oxidative stress, as well as to develop new treatment strategies for these disorders.
气道防御反射,如咽部吞咽、咳嗽和打喷嚏,在维持气道内环境稳定中起关键作用。这些反射由复杂机制控制,主要由脑干中特定的神经元回路(即中枢模式发生器)调节。这些行为还需要气道和消化道内的外周器官(包括鼻子、咽部、喉部和气管)处于最佳状态,这些器官对于确保适当的反应性和运动输出至关重要。氧化应激与这些行为功能受损的发生和进展有关。由中枢或外周损伤(如相关神经元网络的神经退行性变和喉部脱敏)引起的吞咽困难,可能与氧化应激水平升高有关。下呼吸道的慢性炎症和过敏性气道致敏(包括哮喘)会提高氧化应激水平,并降低抗氧化防御酶的活性,从而加剧呼吸道疾病的严重程度。抗氧化剂补充剂通过促进扭曲的气道防御反射的恢复提供了有前景的治疗益处,尽管关于治疗策略的信息有限。有必要进一步开展研究,以加深我们对与氧化应激相关的吞咽困难和气道疾病病理生理学的理解,并为这些疾病开发新的治疗策略。