哮喘治疗中的免疫调节剂
2009/07/09
哮喘是一组以气道炎症为主要表现的综合征，病理机制较为复杂。免疫学发病机制的研究是目前哮喘研究的一大热点，而且也为哮喘治疗的生物学干预提供了契机。
本研究通过文献检索，综述当前用于哮喘治疗的免疫调节剂。这些治疗包括：通过Toll样受体9（TLR9）活化树突状细胞的治疗策略；采用细胞因子阻断剂或单克隆抗体干扰T(H)2细胞因子的作用；促进T(H)1细胞反应；干扰肥大细胞信号传递；阻断IgE介导的信号通路以及阻断TNF-α等。
Omalizumab是目前唯一一个批准用于哮喘治疗的生物制剂，已有实验/试验证实了其治疗哮喘的有效性。随着对哮喘异质性了解的深入，我们应该考虑到针对不同疾病基因型的特异性治疗中的特定靶位治疗，其中就包括免疫调节剂。
（林江涛 审校）
Allergy Asthma Proc. 2009 Mar;30(2):109-119.
Immunomodulators in the treatment of asthma.
Long AA.
Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts.
Asthma represents a syndrome of airway inflammatory diseases with a complex pathology. The immunologic pathogenesis is being increasingly revealed and provides opportunity for targeted biological intervention. This study was designed to describe current experience with immunomodulators as targeted therapy in asthma. A literature review was performed. Targeted therapies have included strategies to activate dendritic cells through the Toll-like receptor (TLR) 9 receptors, to interrupt the action of T(H)2 cytokines with cytokine blockers and monoclonal antibodies, to promote development of T(H)1 responses, to interrupt mast cell signaling, to block IgE mediated pathways, and to block TNF-alpha. Omalizumab is the only biological therapy that has an approved indication in asthma at this time. Improved understanding of the heterogeneity of asthma should allow for specific targeting of different disease phenotype-specific therapies including immunomodulators.
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反复中等强度有氧训练能降低哮喘小鼠的气道反应性
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口服低剂量细胞因子治疗过敏性哮喘
