糖皮质激素对嗅上皮再生的影响

Effects of glucocorticoids on olfactory epithelial regeneration

嗅觉是一种复杂的感觉系统,嗅上皮(OE)中的嗅觉神经元能够感受气味分子并传递嗅觉信号。OE具有强大的自我修复和再生功能,即使在神经元大量死亡的情况下亦可快速再生修复缺损。OE的再生速度及嗅觉功能恢复的程度取决于病变性质(如创伤、化学损伤、感染、炎症等)。糖皮质激素(如地塞米松)常规用于治疗慢性鼻窦炎等上呼吸道炎症,旨在最小化炎症损伤及改善鼻腔嗅觉障碍,新的证据表明这些药物可能会损伤OE的再生能力。本文讨论糖皮质激素对OE再生的影响及其可能的作用机制,为减轻其副作用提出新的诊疗方案。

Olfactory is a complex sensory system in which olfactory neurons in the olfactory epithelium can detect odor molecules and transmit olfactory signals.Olfactory epithelium(OE)has the capacity of self-repair and renewal,which can quickly regenerate and replenish even after massive neuronal cell loss.The degree of olfactory function recovery after OE injury may depend on the nature of the lesion(traumatic,chemical,infectious or inflammatory),as well on the velocity of cellular regeneration.Glucocorticoids(such as dexamethasone)are routinely used to treat upper respiratory tract inflammation such as chronic sinusitis,with the goal of minimizing inflammation and improving olfactory dysfunction.New evidence suggests that glucocorticoids may damage the regeneration of the olfactory epithelium.Here we discuss the effects of glucocorticoids on olfactory epithelial regeneration and the mechanism involved in glucocorticoid deleterious effects on OE regeneration and possible therapeutic alternatives considering relevant side effects.