Shiels I A, Bowler S D, Taylor S M
Department of Physiology and Pharmacology, University of Queensland, St Lucia, Brisbane, Australia.
Med Hypotheses. 1995 Jul;45(1):37-40. doi: 10.1016/0306-9877(95)90198-1.
Proliferation of the non-vascular smooth muscle in the walls of the bronchi and bronchioles is a prominent histopathological feature of asthma and is thought to contribute to airway hyperreactivity and narrowing. Increased vascular permeability with plasma leakage is also a feature of asthma pathology and causes submucosal oedema. We hypothesize that, in asthmatics, the accumulation of enriched plasma in the environment surrounding airway smooth muscle promotes respiratory smooth muscle mitogenesis and hyperplasia. This situation represents the in vivo correlate of the increase in airway smooth muscle cell growth seen in vitro with increasing concentrations of serum in the culture medium. Thus, we hypothesize that vascular leakage in the airways in asthma is a primary pathogenic event leading to airway smooth muscle hyperplasia and hypertrophy, and consequently airway narrowing, promoting the characteristic bronchial hyperreactivity associated with narrowing of the airway lumen.
支气管和细支气管壁中非血管平滑肌的增殖是哮喘突出的组织病理学特征，被认为与气道高反应性和狭窄有关。血管通透性增加伴血浆渗漏也是哮喘病理的一个特征，并导致粘膜下水肿。我们推测，在哮喘患者中，气道平滑肌周围环境中富含血浆的积聚促进了呼吸道平滑肌的有丝分裂和增生。这种情况代表了在体外随着培养基中血清浓度增加而出现的气道平滑肌细胞生长增加的体内相关情况。因此，我们推测哮喘气道中的血管渗漏是导致气道平滑肌增生和肥大的主要致病事件，进而导致气道狭窄，促进与气道腔狭窄相关的特征性支气管高反应性。
