过敏性哮喘的研究进展

Latest research topics on allergic asthma

过敏性哮喘患病率在世界多地区呈现快速上升。其发病机制与复杂的遗传背景和环境因素相关。屏障系统如气道上皮细胞接受刺激,分泌介质,传递信号活化局部组织微环境中天然免疫系统细胞,如天然淋巴样细胞(ILC),及许多效应分子被上调或下调。这些免疫微环境的改变与获得性免疫系统交互作用而启动疾病过程。其中2型ILC能与神经递质相互作用提示神经系统与区域免疫系统交互作用调节局部组织功能。有证据显示表观基因组变化、黏膜微生态改变等,均参与疾病始动、发展及转归。对疾病表型的更深入认识,能有助于从根据病人疾病表型选择治疗,而转向根据疾病机制选择适合治疗方案的病人。此外,对治疗方案的选择和评估,均需要有更多更可靠的生物标志物。实验研究也需要更能真实映象人体的实验模型。本文综述这些方面近年来的研究进展。

The prevalence of allergic asthma has been growing steadily worldwide including China.Complex genetic and envi-ronmental factors have been assumed to contribute to disease pathogenesis.Key players in the barrier system such as airway epithelia secret allergic mediators in response to allergen stimulation.The micro-environment composed of innate immune cells,e.g.,innate lymphoid cells,and various immune effector molecules is critical in regulating the production of cytokines/chemokines,which further impacts the cells in adaptive immunity.The revelation of the neuron-ILC2 axis confirms the importance of the cross-talk between the nervous system and local immune responses on the regulation of tissue homeostasis.Furthermore,accumulating data implicate the involvement of the epigenetics and microbiota in allergic diseases.The concept of endotype has improved personalized medicine that aims to select the most suitable patient for a therapy according to the patient-specific patterns of disease pathology.There is also a demand for more precise biomarkers that can identify the appropriate treatment recipient.Lastly,the validity of experimental animal models of allergic asthma may need to be re-evaluated.This review summarizes recent progress addressing these issues in our understanding of allergic pathology.