Airway inflammation

气道炎症
  • 文章类型: Journal Article
    背景:气道上皮细胞(AEC)坏死导致气道过敏性炎症和哮喘加重。靶向肿瘤坏死因子样配体1A(TL1A)/死亡受体3(DR3)轴对哮喘气道炎症有治疗作用。TL1A在介导卵清蛋白(OVA)攻击的AECs坏死中的作用及其对气道炎症的贡献尚不清楚。
    方法:我们评估了受体相互作用的丝氨酸/苏氨酸蛋白激酶3(RIPK3)和混合谱系激酶结构域样蛋白(MLKL)在人血清和肺中的表达,并在组织学上验证了哮喘和OVA诱导的小鼠肺组织中MLKL磷酸化的水平。接下来,使用MLKL基因敲除小鼠和RIPK3抑制剂GSK872,我们研究了TL1A通过激活实验性哮喘的坏死性凋亡对气道炎症和气道屏障功能的影响。
    结果:在哮喘患者血清中观察到坏死标记蛋白的高表达,哮喘和OVA诱导的小鼠的气道上皮都激活了坏死。通过MLKL敲除或RIPK3抑制阻断坏死性凋亡可有效减轻支气管旁炎症,粘液分泌过多,和气道胶原纤维的积累,同时还抑制2型炎症因子的分泌。此外,通过在HBE细胞中沉默或过表达TL1A,TL1A/DR3显示在不存在胱天蛋白酶的情况下充当坏死的死亡触发因素。此外,发现重组TL1A蛋白在体内诱导坏死,MLKL的敲除部分逆转了TL1A诱导的病理变化。TL1A诱导的坏死通过降低紧密连接蛋白小带闭塞蛋白1(ZO-1)和闭塞蛋白的表达来破坏气道屏障功能,可能通过激活NF-κB信号通路。
    结论:TL1A诱导的气道上皮坏死在促进哮喘气道炎症和屏障功能障碍中起重要作用。抑制TL1A诱导的坏死途径可能是一种有前途的治疗策略。
    BACKGROUND: Airway epithelial cell (AEC) necroptosis contributes to airway allergic inflammation and asthma exacerbation. Targeting the tumor necrosis factor-like ligand 1 A (TL1A)/death receptor 3 (DR3) axis has a therapeutic effect on asthmatic airway inflammation. The role of TL1A in mediating necroptosis of AECs challenged with ovalbumin (OVA) and its contribution to airway inflammation remains unclear.
    METHODS: We evaluated the expression of the receptor-interacting serine/threonine-protein kinase 3(RIPK3) and the mixed lineage kinase domain-like protein (MLKL) in human serum and lung, and histologically verified the level of MLKL phosphorylation in lung tissue from asthmatics and OVA-induced mice. Next, using MLKL knockout mice and the RIPK3 inhibitor GSK872, we investigated the effects of TL1A on airway inflammation and airway barrier function through the activation of necroptosis in experimental asthma.
    RESULTS: High expression of necroptosis marker proteins was observed in the serum of asthmatics, and necroptosis was activated in the airway epithelium of both asthmatics and OVA-induced mice. Blocking necroptosis through MLKL knockout or RIPK3 inhibition effectively attenuated parabronchial inflammation, mucus hypersecretion, and airway collagen fiber accumulation, while also suppressing type 2 inflammatory factors secretion. In addition, TL1A/ DR3 was shown to act as a death trigger for necroptosis in the absence of caspases by silencing or overexpressing TL1A in HBE cells. Furthermore, the recombinant TL1A protein was found to induce necroptosis in vivo, and knockout of MLKL partially reversed the pathological changes induced by TL1A. The necroptosis induced by TL1A disrupted the airway barrier function by decreasing the expression of tight junction proteins zonula occludens-1 (ZO-1) and occludin, possibly through the activation of the NF-κB signaling pathway.
    CONCLUSIONS: TL1A-induced airway epithelial necroptosis plays a significant role in promoting airway inflammation and barrier dysfunction in asthma. Inhibition of the TL1A-induced necroptosis pathway could be a promising therapeutic strategy.
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  • 文章类型: Clinical Trial
    背景:电子香烟(EC)已被推广为传统香烟的替代品。
    目的:为了研究ECs对呼吸系统的影响,尤其是呼吸道疾病患者。
    方法:我们随机选择25名中度哮喘稳定期吸烟者,并与25名健康吸烟者进行匹配。所有患者均接受肺功能检查(PFTs),脉冲振荡法(IOS),呼出气一氧化氮(FeNO),吸一种含尼古丁的EC之前和之后的呼出呼吸冷凝液(EBC)和生物标志物测量。
    结果:EC30分钟后FeNO的增加,反映气道炎症,与剩余体积(RV)的增加显着相关,肺总容量,5Hz时的呼吸阻抗(Z5Hz)和5和20Hz时的呼吸阻抗(R5Hz和R20Hz)。在EBC生物标志物的变化和呼吸力学之间没有发现显著的相关性。
    结论:这是第一项研究,证明EC引起的气道炎症变化对哮喘患者的呼吸力学有直接影响。
    BACKGROUND: Electronic cigarettes (ECs) have been promoted as alternatives to traditional cigarettes.
    OBJECTIVE: To investigate ECs\' effects on respiratory system, especially in patients with respiratory diseases.
    METHODS: We randomly selected 25 smokers with stable moderate asthma and matched them with 25 healthy smokers. All were subjucted to pulmonary function tests (PFTs), impulse oscillometry (IOS), fraction exhaled Nitric Oxide (FeNO), exhaled breathe condensate (EBC) and biomarker measurements before and after vaping one nicotine-containing EC.
    RESULTS: The increase in FeNO 30 minutes after EC, reflecting airway inflammation, significantly correlated with increase of residual volume (RV), total lung capacity, respiratory impedance at 5 Hz (Z5Hz) and respiratory resistance at 5 and 20 Hz (R5Hz and R20Hz). No significant correlations were found between EBC biomarkers\' changes and respiratory mechanics.
    CONCLUSIONS: This is the first study demonstrating that the changes in airway inflammation caused by EC have direct effects in respiratory mechanics of asthmatic patients.
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  • 文章类型: Journal Article
    背景:淫羊藿苷(ICA)抑制各种疾病的炎症反应,但ICA治疗哮喘气道炎症的潜在机制有待进一步了解。我们旨在通过网络药理学和实验来预测和验证ICA对抗哮喘相关气道炎症的潜在靶点。
    方法:建立卵清蛋白诱导的哮喘相关气道炎症小鼠模型。ICA的影响是通过行为评估的,气道高反应性,肺病理变化,炎症细胞和细胞因子计数。接下来,ICA的相应目标是通过SEA开采的,CTD,HERB,PharmMapper,Symmap数据库和文献。Pubmed-Gene和GeneCards数据库用于筛选哮喘和气道炎症相关靶标。重叠的目标被用来建立一个互动网络,分析基因本体论并丰富通路。随后,流式细胞术,采用定量实时PCR和蛋白质印迹进行验证。
    结果:ICA减轻了哮喘的气道炎症;ICA的402个靶标,筛选了5136个哮喘目标和4531个气道炎症目标;匹配了216个重叠目标,预测ICA具有通过巨噬细胞激活/极化调节哮喘气道炎症的潜力。此外,ICA降低M1但升高M2。通过ICA治疗,哮喘炎症破坏的潜在目标得以恢复。
    结论:ICA通过抑制肺泡巨噬细胞M1极化减轻哮喘气道炎症,这与代谢重编程有关。Jun,Jak2Syk,Tnf,Aldh2、Aldh9a1、Nos1、Nos2和Nos3代表治疗干预的潜在目标。本研究增强了对ICA的抗气道炎症作用的理解,尤其是哮喘。
    BACKGROUND: Icariin (ICA) inhibits inflammatory response in various diseases, but the mechanism underlying ICA treating airway inflammation in asthma needs further understood. We aimed to predict and validate the potential targets of ICA against asthma-associated airway inflammation using network pharmacology and experiments.
    METHODS: The ovalbumin-induced asthma-associated airway inflammation mice model was established. The effects of ICA were evaluated by behavioral, airway hyperresponsiveness, lung pathological changes, inflammatory cell and cytokines counts. Next, the corresponding targets of ICA were mined via the SEA, CTD, HERB, PharmMapper, Symmap database and the literature. Pubmed-Gene and GeneCards databases were used to screen asthma and airway inflammation-related targets. The overlapping targets were used to build an interaction network, analyze gene ontology and enrich pathways. Subsequently, flow cytometry, quantitative real-time PCR and western blotting were employed for validation.
    RESULTS: ICA alleviated the airway inflammation of asthma; 402 targets of ICA, 5136 targets of asthma and 4531 targets of airway inflammation were screened; 216 overlapping targets were matched and predicted ICA possesses the potential to modulate asthmatic airway inflammation by macrophage activation/polarization. Additionally, ICA decreased M1 but elevated M2. Potential targets that were disrupted by asthma inflammation were restored by ICA treatment.
    CONCLUSIONS: ICA alleviates airway inflammation in asthma by inhibiting the M1 polarization of alveolar macrophages, which is related to metabolic reprogramming. Jun, Jak2, Syk, Tnf, Aldh2, Aldh9a1, Nos1, Nos2 and Nos3 represent potential targets of therapeutic intervention. The present study enhances understanding of the anti-airway inflammation effects of ICA, especially in asthma.
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  • 文章类型: Journal Article
    超细颗粒(UFP)对健康的影响日益受到全球关注,但是流行病学证据仍然有限。以低氧血症为特征的睡眠呼吸紊乱(SDB)是与许多使人衰弱的慢性疾病相关的普遍状况。然而,缺乏UFP在SDB发展中的作用。因此,这项前瞻性小组研究旨在专门研究慢性阻塞性肺疾病(COPD)患者短期UFPs暴露与SDB参数的相关性.91例COPD患者在北京完成了226次临床就诊,中国。根据渗透系数和时间活动模式估计个人暴露于0-7天的环境UFP。实时监测睡眠氧饱和度,肺活量测定,每次临床访视时进行呼吸道问卷调查和气道炎症检测.使用广义估计方程来估计UFP的效果。暴露于UFP与氧饱和度降低指数(ODI)和氧饱和度低于90%(T90)的时间百分比显着相关,估计为21.50%(95CI:6.38%,38.76%)和18.75%(95CI:2.83%,37.14%),分别,在滞后0-3小时时,每3442个颗粒/cm3的UFP增量。特别是,UFPs暴露在0-7天内与肺泡一氧化氮(CaNO)浓度呈正相关,通过CaNO超过5ppb测量的肺泡嗜酸性粒细胞炎症分别与ODI和T90的29.63%和33.48%增加相关。此外,在当前吸烟者中观察到对氧饱和度的放大效应。值得注意的是,肺功能和活动耐受性较好的个体由于户外活动时间较长而受到环境UFP的影响更大.据我们所知,这是第一项将UFPs与睡眠期间低氧血症联系起来并揭示肺泡嗜酸性粒细胞炎症的关键作用的研究.我们的发现为UFP的作用谱以及潜在的环境和行为干预策略提供了新的见解,以保护易感人群。
    The health effects of ultrafine particles (UFPs) are of growing global concern, but the epidemiological evidence remains limited. Sleep-disordered breathing (SDB) characterized by hypoxemia is a prevalent condition linked to many debilitating chronic diseases. However, the role of UFPs in the development of SDB is lacking. Therefore, this prospective panel study was performed to specifically investigate the association of short-term exposure to UFPs with SDB parameters in patients with chronic obstructive pulmonary disease (COPD). Ninety-one COPD patients completed 226 clinical visits in Beijing, China. Personal exposure to ambient UFPs of 0-7 days was estimated based on infiltration factor and time-activity pattern. Real-time monitoring of sleep oxygen saturation, spirometry, respiratory questionnaires and airway inflammation detection were performed at each clinical visit. Generalized estimating equation was used to estimate the effects of UFPs. Exposure to UFPs was significantly associated with increased oxygen desaturation index (ODI) and percent of the time with oxygen saturation below 90 % (T90), with estimates of 21.50 % (95%CI: 6.38 %, 38.76 %) and 18.75 % (95%CI: 2.83 %, 37.14 %), respectively, per 3442 particles/cm3 increment of UFPs at lag 0-3 h. Particularly, UFPs\' exposure within 0-7 days was positively associated with the concentration of alveolar nitric oxide (CaNO), and alveolar eosinophilic inflammation measured by CaNO exceeding 5 ppb was associated with 29.63 % and 33.48 % increases in ODI and T90, respectively. In addition, amplified effects on oxygen desaturation were observed in current smokers. Notably, individuals with better lung function and activity tolerance were more affected by ambient UFPs due to longer time spent outdoors. To our knowledge, this is the first study to link UFPs to hypoxemia during sleep and uncover the key role of alveolar eosinophilic inflammation. Our findings provide new insights into the effect spectrum of UFPs and potential environmental and behavioral intervention strategies to protect susceptible populations.
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  • 文章类型: Journal Article
    背景:颗粒β-葡聚糖(WGP)是在各种生物过程中具有调节作用的天然化合物,包括肿瘤发生和炎症性疾病,如过敏性哮喘。然而,它们对肥大细胞(MC)的影响,哮喘小鼠气道高反应性(AHR)和炎症的贡献者,仍然未知。
    方法:C57BL/6小鼠在没有明矾的情况下反复进行OVA致敏,其次是卵清蛋白(OVA)挑战。小鼠在致敏和攻击前每天口服50或150mg/kg剂量的WGP(OAW)。我们评估了气道功能,肺组织病理学,气道中的肺部炎症细胞成分,以及支气管肺泡灌洗液(BALF)中的促炎细胞因子和趋化因子。
    结果:150mg/kgOAW治疗减轻了OVA诱导的AHR和气道炎症,气道对雾化乙酰甲胆碱(Mch)的反应性降低证明,炎性细胞浸润减少,肺组织杯状细胞增生。此外,OAW阻碍了炎症细胞的募集,包括MC和嗜酸性粒细胞,在肺组织和BALF中。OAW治疗可减弱BALF中的促炎性肿瘤坏死因子(TNF)-α和IL-6水平。值得注意的是,OAW显著下调趋化因子CCL3、CCL5、CCL20、CCL22、CXCL9和CXCL10在BALF中的表达。
    结论:这些结果突出了OAW的强大抗炎特性,提示通过影响炎症细胞浸润和调节气道中的促炎细胞因子和趋化因子治疗MC依赖性AHR和过敏性炎症的潜在益处。
    BACKGROUND: Particulate β-glucans (WGP) are natural compounds with regulatory roles in various biological processes, including tumorigenesis and inflammatory diseases such as allergic asthma. However, their impact on mast cells (MCs), contributors to airway hyperresponsiveness (AHR) and inflammation in asthma mice, remains unknown.
    METHODS: C57BL/6 mice underwent repeated OVA sensitization without alum, followed by Ovalbumin (OVA) challenge. Mice received daily oral administration of WGP (OAW) at doses of 50 or 150 mg/kg before sensitization and challenge. We assessed airway function, lung histopathology, and pulmonary inflammatory cell composition in the airways, as well as proinflammatory cytokines and chemokines in the bronchoalveolar lavage fluid (BALF).
    RESULTS: The 150 mg/kg OAW treatment mitigated OVA-induced AHR and airway inflammation, evidenced by reduced airway reactivity to aerosolized methacholine (Mch), diminished inflammatory cell infiltration, and goblet cell hyperplasia in lung tissues. Additionally, OAW hindered the recruitment of inflammatory cells, including MCs and eosinophils, in lung tissues and BALF. OAW treatment attenuated proinflammatory tumor necrosis factor (TNF)-α and IL-6 levels in BALF. Notably, OAW significantly downregulated the expression of chemokines CCL3, CCL5, CCL20, CCL22, CXCL9, and CXCL10 in BALF.
    CONCLUSIONS: These results highlight OAW\'s robust anti-inflammatory properties, suggesting potential benefits in treating MC-dependent AHR and allergic inflammation by influencing inflammatory cell infiltration and regulating proinflammatory cytokines and chemokines in the airways.
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  • 文章类型: Journal Article
    三磷酸腺苷(ATP)可以响应于广泛的物理或化学应激而从各种类型的细胞释放到细胞外环境中。在呼吸道,细胞外ATP被认为是气道炎症的重要信号分子和触发因素。氯(Cl2),二氧化硫(SO2),氨(NH3)是强效刺激性气体和常见的工业空气污染物,因为它们广泛用作化学试剂。这项研究是为了确定这些刺激性气体的急性吸入挑战,在模拟工业操作中意外暴露于这些化学气体的浓度和持续时间,触发了大鼠呼吸道中ATP的释放;如果是这样,支气管肺泡灌洗液(BALF)中的ATP水平是否因慢性过敏性气道炎症而升高。我们的结果表明:1)吸入这些刺激性气体导致BALF中ATP水平显着增加,诱发ATP释放的幅度依次为Cl2>SO2>NH3。2)卵清蛋白致敏引起的慢性气道炎症在基线(呼吸室内空气)期间显着升高了BALF中的ATP水平,但并未增强由这些刺激性气体的吸入激发引发的肺中ATP的释放。这些发现表明,肺部ATP释放可能参与调节对急性吸入刺激性气体的总体气道反应和慢性过敏性气道炎症的发病机理。
    Adenosine triphosphate (ATP) can be released into the extracellular milieu from various types of cells in response to a wide range of physical or chemical stresses. In the respiratory tract, extracellular ATP is recognized as an important signal molecule and trigger of airway inflammation. Chlorine (Cl2), sulfur dioxide (SO2), and ammonia (NH3) are potent irritant gases and common industrial air pollutants due to their widespread uses as chemical agents. This study was carried out to determine if acute inhalation challenges of these irritant gases, at the concentration and duration simulating the accidental exposures to these chemical gases in industrial operations, triggered the release of ATP in the rat respiratory tract; and if so, whether the level of ATP in bronchoalveolar lavage fluid (BALF) evoked by inhalation challenge of a given irritant gas was elevated by chronic allergic airway inflammation. Our results showed: 1) Inhalation of these irritant gases caused significant increases in the ATP level in BALF, and the magnitude of evoked ATP release was in the order of Cl2 > SO2 > NH3. 2) Chronic airway inflammation induced by ovalbumin-sensitization markedly elevated the ATP level in BALF during baseline (breathing room air) but did not potentiate the release of ATP in the lung triggered by inhalation challenges of these irritant gases. These findings suggested a possible involvement of the ATP release in the lung in the regulation of overall airway responses to acute inhalation of irritant gases and the pathogenesis of chronic allergic airway inflammation.
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  • 文章类型: Journal Article
    轻度-中度和重度马哮喘(MEA和SEA)是普遍的炎症气道疾病,影响许多品种和学科的马。尽管进行了广泛的研究,详细的疾病病理生理学以及MEA和SEA之间的差异仍未完全了解。支气管肺泡灌洗液细胞学,广泛应用于临床实践和马哮喘研究,代表下气道炎症状态的手段有限。脂质组学是可用于研究细胞机制和细胞间相互作用的科学领域。脂质组学的研究有各种各样的焦点,其中脂肪酸和脂质介质谱分析和全球脂质组学已在兽医学中实施。由于许多关键的促炎和促分解介质是脂质,脂质组学研究为研究马气道的炎症反应提供了一种有趣但尚未探索的方法。这篇综述的目的是收集和总结最近关于马气道炎症的脂质组学研究的发现。
    Mild-moderate and severe equine asthma (MEA and SEA) are prevalent inflammatory airway conditions affecting horses of numerous breeds and disciplines. Despite extensive research, detailed disease pathophysiology and the differences between MEA and SEA are still not completely understood. Bronchoalveolar lavage fluid cytology, broadly used in clinical practice and in equine asthma research, has limited means to represent the inflammatory status in the lower airways. Lipidomics is a field of science that can be utilized in investigating cellular mechanisms and cell-to-cell interactions. Studies in lipidomics have a broad variety of foci, of which fatty acid and lipid mediator profile analyses and global lipidomics have been implemented in veterinary medicine. As many crucial proinflammatory and proresolving mediators are lipids, lipidomic studies offer an interesting yet largely unexplored means to investigate inflammatory reactions in equine airways. The aim of this review article is to collect and summarize the findings of recent lipidomic studies on equine airway inflammation.
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  • 文章类型: English Abstract
    OBJECTIVE: To explore the effects of iris xanthin on airway inflammation, airway remodeling, and the high mobility group box 1 protein (HMGB1)/Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) pathway in asthmatic young mice.
    METHODS: Sixty male BALB/c young mice were randomly assigned into six groups: a blank group, a model group, a dexamethasone group, and low, medium, and high dose groups of iris xanthin, with ten mice per group. Asthma models were induced through intraperitoneal injections of a sensitizing agent [ovalbumin (OVA) 20 μg + aluminum hydroxide gel 2 mg], followed by 4% OVA aerosol inhalation. Lung function was measured using a pulmonary function tester to determine lung volume (LV), resting ventilation per minute (VE), and airway reactivity (Penh value). Hematoxylin-eosin (HE) staining was employed to examine and analyze airway remodeling. The contents of interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) in bronchoalveolar lavage fluid were quantified using ELISA. Real-time fluorescence quantitative polymerase chain reaction and Western blot analysis were used to assess the expression of HMGB1/TLR4/NF-κB pathway-related mRNA and proteins in lung tissues.
    RESULTS: Compared to the model group, the dexamethasone and iris xanthin-treated groups (low, medium, and high doses) exhibited significant increases in LV and VE (P<0.05), with incremental dose-dependent increases observed in the iris xanthin groups. Additionally, Penh values, IL-1β, IL-6, TNF-α, and airway remodeling indicators, along with mRNA levels of HMGB1, TLR4, and NF-κB p65 and protein levels of HMGB1, TLR4, and p-NF-κB p65, were all reduced (P<0.05) in a dose-dependent manner. When compared to the dexamethasone group, the low and medium dose iris xanthin groups showed decreases in LV and VE (P<0.05), whereas Penh values, IL-1β, IL-6, TNF-α, and airway remodeling indicators, along with mRNA levels of HMGB1, TLR4, NF-κB p65 and protein levels of HMGB1, TLR4, and p-NF-κB p65, were increased (P<0.05). No significant differences were noted in these indices between the high dose iris xanthin group and the dexamethasone group (P>0.05).
    CONCLUSIONS: Iris xanthin can effectively alleviates airway inflammation and inhibits airway remodeling in asthmatic young mice, possibly through the suppression of the HMGB1/TLR4/NF-κB pathway.
    目的: 探究鸢尾黄素对哮喘幼鼠气道炎症、气道重塑及高迁移率族蛋白B1(high mobility group box 1 protein, HMGB1)/Toll样受体4(Toll-like receptor 4, TLR4)/核因子κB(nuclear factor-κB, NF-κB)通路的影响。方法: 将60只雄性BALB/c幼鼠随机分为空白组、模型组、地塞米松组,以及鸢尾黄素低、中、高剂量组,每组10只。采用腹腔注射致敏剂[卵清蛋白(ovalbumin, OVA)20 μg+氢氧化铝凝胶2 mg]+4% OVA雾化吸入激发建立幼鼠哮喘模型。肺功能检测仪检测幼鼠肺容积(lung volume, LV)、每分钟静息通气量(resting ventilation per minute, VE)及气道反应性(Penh值);苏木精-伊红染色观察并分析气道重塑情况;ELISA法检测肺泡灌洗液中白介素(interleukin, IL)-1β、IL-6、肿瘤坏死因子α(tumor necrosis factor alpha, TNF-α)含量;实时定量逆转录聚合酶链反应及Western blot法检测肺组织中HMGB1/TLR4/NF-κB通路相关mRNA及蛋白表达。结果: 与模型组比较,地塞米松组及鸢尾黄素低、中、高剂量组LV、VE均显著升高(P<0.05),其中鸢尾黄素各剂量组随剂量增加LV、VE升高(P<0.05);地塞米松组及鸢尾黄素低、中、高剂量组Penh值、IL-1β、IL-6、TNF-α、气道重塑指标,以及HMGB1、TLR4、NF-κB p65 mRNA和HMGB1、TLR4、p-NF-κB p65蛋白表达水平均降低(P<0.05),其中鸢尾黄素各剂量组随剂量增加上述指标降低(P<0.05)。与地塞米松组比较,鸢尾黄素低、中剂量组LV、VE均降低(P<0.05),Penh值、IL-1β、IL-6、TNF-α、气道重塑指标,以及HMGB1、TLR4、NF-κB p65 mRNA和HMGB1、TLR4、p-NF-κB p65蛋白表达水平均升高(P<0.05);鸢尾黄素高剂量组上述指标与地塞米松组比较差异无统计学意义(P>0.05)。结论: 鸢尾黄素能有效减轻哮喘幼鼠气道炎症,抑制气道重塑,可能与抑制HMGB1/TLR4/NF-κB通路有关。.
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  • 文章类型: Journal Article
    慢性咳嗽是一种常见疾病,持续时间超过8周,影响所有年龄组。支持中性粒细胞在慢性咳嗽病理中的作用的证据是基于许多慢性咳嗽发展为气道中性粒细胞增多症的患者。中性粒细胞如何影响慢性咳嗽的发展尚不清楚。然而,它们可能涉及咳嗽病因的多个方面,包括促进气道炎症,气道重塑,超响应性,局部神经源性炎症,和其他可能的机制。嗜中性粒细胞气道炎症也与难治性咳嗽有关,对基础疾病控制不力(例如,哮喘),对止咳药治疗不敏感。在慢性咳嗽中靶向中性粒细胞的潜力需要探索,包括开发针对一种或多种中性粒细胞介导途径或改变中性粒细胞表型以缓解慢性咳嗽的新药。气道微生物组的不同,扮演一个角色,以及与中性粒细胞在不同咳嗽病因中的相互作用知之甚少。未来的研究应集中在了解气道微生物组和中性粒细胞之间的关系。
    Chronic cough is a common disorder lasting more than 8 weeks and affecting all age groups. The evidence supporting the role of neutrophils in chronic cough pathology is based on many patients with chronic cough developing airway neutrophilia. How neutrophils influence the development of chronic cough is unknown. However, they are likely involved in multiple aspects of cough etiology, including promoting airway inflammation, airway remodeling, hyper-responsiveness, local neurogenic inflammation, and other possible mechanisms. Neutrophilic airway inflammation is also associated with refractory cough, poor control of underlying diseases (e.g., asthma), and insensitivity to cough suppressant therapy. The potential for targeting neutrophils in chronic cough needs exploration, including developing new drugs targeting one or more neutrophil-mediated pathways or altering the neutrophil phenotype to alleviate chronic cough. How the airway microbiome differs, plays a role, and interacts with neutrophils in different cough etiologies is poorly understood. Future studies should focus on understanding the relationship between the airway microbiome and neutrophils.
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  • 文章类型: Journal Article
    对β-2激动剂安全性的担忧导致了对主要哮喘指南的修订,以更好地解决这些问题。尽管这些更新允许结合以前和当前的策略,他们可能会混淆临床医生。β-2激动剂对于通过放松平滑肌来缓解哮喘症状至关重要;然而,它们还通过在体外和体内诱导促炎介质而构成重大风险.除了过度使用和症状掩盖的风险,在哮喘加重期间,单独使用治疗剂量的β-激动剂可使气道炎症恶化,并增强病毒诱导的炎症.吸入糖皮质激素(ICS)可以有效预防这些不良反应。随着对这些不良事件机制的新见解,保留短效β-激动剂用于急性加重期间的急性症状缓解,并且仅适用于已经使用ICS或口服类固醇的患者,这是一种谨慎的方法,即在哮喘患者中使用β-激动剂,副作用最小.然而,这种方法的一个主要缺点是潜在的不遵守ICS,导致β-激动剂的使用,而无需ICS的必要反作用。最优策略,在恶化期间和外部,将β-激动剂整合到包括ICS的抗炎方案中,理想情况下与相同的吸入器结合使用,以确保在财务允许的情况下同时使用。这将保持β-激动剂的有益效果,如支气管扩张,同时防止炎症介质诱导的不良反应。这种方法与不同的临床环境相一致,最大限度地安全使用β-激动剂,并支持全面的符合指导方针的管理战略。
    Concerns regarding the safety of beta-2 agonists have led to revisions of the major asthma guidelines to better address these issues. Although these updates allow for a combination of previous and current strategies, they may confuse clinical practitioners. Beta-2 agonists are vital for alleviating asthma symptoms by relaxing smooth muscles; however, they also pose significant risks by inducing pro-inflammatory mediators both in vitro and in vivo. In addition to the risks of overuse and symptom masking, the use of beta-agonists alone at therapeutic doses can worsen airway inflammation and enhance virus-induced inflammation during asthma exacerbation. Inhaled corticosteroids (ICS) can effectively prevent these adverse effects. With new insights into the mechanisms of these adverse events, reserving short-acting beta-agonists for acute symptom relief during exacerbations and only for those who are already on ICS or oral steroids represents a careful approach to using beta-agonists with least adverse effects in patients with asthma. However, a major drawback of this approach is the potential non-compliance with ICS, leading to beta-agonist use without the necessary counteraction by ICS. An optimal strategy, both during and outside exacerbations, would integrate beta-agonists into an anti-inflammatory regimen that includes ICS, ideally combined with the same inhaler to ensure their concurrent use where finances allow. This would maintain the beneficial effects of beta-agonists, such as bronchodilation, while preventing the adverse effects from the induction of inflammatory mediators. This method is aligned with diverse clinical settings, maximizes the safe use of beta-agonists, and supports a comprehensive guideline-compliant management strategy.
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