Choi D C, Kwon O J
Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
Curr Opin Pulm Med. 1998 Jan;4(1):16-24. doi: 10.1097/00063198-199801000-00004.
Although asthma is considered to be an inflammatory disease of the airways, neural mechanisms remain very important. Neural control of airways is far more complex than has been previously recognized. In addition to the classic neural pathways, the nonadrenergic, noncholinergic pathway has been described in the airways of animals and humans. Neuropeptides are present in sensory, parasympathetic, and sympathetic neurons in airways, and have been shown to have proinflammatory effects, such as increased mucus production, microvascular leakage, and smooth muscle contraction. Neuropeptides released from sensory nerves (eg, neurokinin A and substance P) mediate excitatory nonadrenergic, noncholinergic transmission, which causes bronchoconstriction and, possibly, bronchial hyperresponsiveness. Better understanding of neural mechanisms might provide a useful therapeutic approach in the future.
尽管哮喘被认为是一种气道炎症性疾病，但神经机制仍然非常重要。气道的神经控制远比之前所认识到的更为复杂。除了经典的神经通路外，非肾上腺素能、非胆碱能通路已在动物和人类气道中被描述。神经肽存在于气道的感觉、副交感和交感神经元中，并已被证明具有促炎作用，如增加黏液分泌、微血管渗漏和平滑肌收缩。感觉神经释放的神经肽（如神经激肽A和P物质）介导兴奋性非肾上腺素能、非胆碱能传递，导致支气管收缩，并可能引起支气管高反应性。更好地理解神经机制可能在未来提供一种有用的治疗方法。
