生物钟紊乱和非2型哮喘：免疫、上皮和类固醇反应的假说驱动视角
2025/08/01
摘要
哮喘是一种主要的慢性非传染性呼吸系统疾病，影响全球超过3亿人，成人患病率为4.3%。尽管个体化治疗取得了进展，但仍有一部分患者（尤其是非2型（非t2）哮喘患者）未能实现最佳的疾病控制。非t2型哮喘以激素抵抗和异质性免疫反应为特征，其治疗仍然是一个挑战。越来越多的证据表明，昼夜节律紊乱可能调节与非t2型哮喘相关的关键病理过程，包括免疫失衡、上皮屏障功能障碍和糖皮质激素敏感性受损。本综述探讨了生物钟功能障碍与非2型哮喘发病机制之间关联的证据，并提出了一个假设驱动的框架，以指导未来的研究。时间治疗策略和针对生物钟的干预措施可能为未来的研究和个体化治疗提供有希望的途径。
Circadian Clock Disruption and Non-type 2 Asthma: A Hypothesis-Driven Perspective on Immune, Epithelial, and Steroid Response
Haohua Huang, Xiaoxiao Jiang, Qian Du, Hua Liao, Shaoxi Cai, Hangming Dong
Abstract
Asthma is a major chronic non-communicable respiratory disease, affecting over 300 million individuals globally, with an adult prevalence of 4.3%. Despite advances in individualized treatment, a subset of patients, particularly those with non-type 2 (non-T2) asthma, fails to achieve optimal disease control. Non-T2 asthma, characterized by steroid resistance and heterogeneous immune responses, remains a therapeutic challenge. Emerging evidence suggests that circadian rhythm disruption may modulate key pathological processes relevant to non-T2 asthma, including immune imbalance, epithelial barrier dysfunction, and impaired glucocorticoid sensitivity. This review investigates evidence of an association between circadian clock dysfunction and non-type 2 asthma pathogenesis, and proposes a hypothesis-driven framework to guide future studies. Chronotherapeutic strategies and clock-targeted interventions may offer promising avenues for future research and individualized treatment.
哮喘是一种主要的慢性非传染性呼吸系统疾病，影响全球超过3亿人，成人患病率为4.3%。尽管个体化治疗取得了进展，但仍有一部分患者（尤其是非2型（非t2）哮喘患者）未能实现最佳的疾病控制。非t2型哮喘以激素抵抗和异质性免疫反应为特征，其治疗仍然是一个挑战。越来越多的证据表明，昼夜节律紊乱可能调节与非t2型哮喘相关的关键病理过程，包括免疫失衡、上皮屏障功能障碍和糖皮质激素敏感性受损。本综述探讨了生物钟功能障碍与非2型哮喘发病机制之间关联的证据，并提出了一个假设驱动的框架，以指导未来的研究。时间治疗策略和针对生物钟的干预措施可能为未来的研究和个体化治疗提供有希望的途径。
（中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校）
（Clin Rev Allergy Immunol. 2025 Jul 25;68(1):72. doi: 10.1007/s12016-025-09088-5.）
Circadian Clock Disruption and Non-type 2 Asthma: A Hypothesis-Driven Perspective on Immune, Epithelial, and Steroid Response
Haohua Huang, Xiaoxiao Jiang, Qian Du, Hua Liao, Shaoxi Cai, Hangming Dong
Abstract
Asthma is a major chronic non-communicable respiratory disease, affecting over 300 million individuals globally, with an adult prevalence of 4.3%. Despite advances in individualized treatment, a subset of patients, particularly those with non-type 2 (non-T2) asthma, fails to achieve optimal disease control. Non-T2 asthma, characterized by steroid resistance and heterogeneous immune responses, remains a therapeutic challenge. Emerging evidence suggests that circadian rhythm disruption may modulate key pathological processes relevant to non-T2 asthma, including immune imbalance, epithelial barrier dysfunction, and impaired glucocorticoid sensitivity. This review investigates evidence of an association between circadian clock dysfunction and non-type 2 asthma pathogenesis, and proposes a hypothesis-driven framework to guide future studies. Chronotherapeutic strategies and clock-targeted interventions may offer promising avenues for future research and individualized treatment.
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纤维胶凝蛋白A通过抑制ILC2驱动的2型炎症来预防过敏性哮喘
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哮喘黏液栓的细胞和分子特征提供了有关其形成和持续存在的线索
