白三烯调剂在儿童哮喘治疗中作用和地位.pptVIP

Slides 9 Slide 4: Factors Contributing to the Systemic Manifestations of Inflammation in the Respiratory System: A Working Hypothesis Continued… The immune-response hypothesis gives importance to the route of exposure, which could be via inhaled air, via postnasal drip, or by way of circulating inflammatory mediators newly formed in response to environmental factors. The inflammatory effectors would be delivered through the systemic circulation to target tissues. The specific type and degree of immune response determine or modulate the systemic manifestation of the allergy as an IgE response or as a non-IgE, primary T-cell response. Other factors, such as T-cell homing, play a role in the manifestation of the allergic inflammation in specific target organs, such as the lower airway, the nose, or other tissues (eg, the skin).1,3,4? References: 1. Sicherer SH. Determinants of systemic manifestations of food allergy. J Allergy Clin Immunol. 2000;106(5):S251– S257. 2. Busse WW, Lemanske RF Jr. Asthma. N Engl J Med. 2001;344:350–362. 3. Kay AB. Allergy and allergic diseases. First of two parts. N Engl J Med. 2001;344:30–37. 4. Ainslie MP, McNulty CA, Huynh T, Symon FA, Wardlaw AJ. Characterisation of adhesion receptors mediating lymphocyte adhesion to bronchial endothelium provides evidence for a distinct lung homing pathway. Thorax. Dec 2002;57:1054–1059. Slides 10 白三烯是哮喘重要的炎症介质，在哮喘的速发相反应和迟发相反应中均发挥重要的作用 效应是通过受体发挥作用的。 现在已经分离出两种亚型的半胱氨酰白三烯受体：CysLT1受体和CysLT2受体。 在哮喘病理过程中，白三烯具有趋化性，能促进气管平滑肌收缩、增加血管通透性等。这些效应主要由CysLT1受体介导。 CysLT1 受体在炎症细胞的表达（红色荧光）：淋巴细胞、单核细胞、嗜酸性粒细胞、巨噬细胞等。 Slide 11 图示为白三烯受体（红色）在肺组织的表达。 CysLT1受体位于中心大气道和周围小气道的平滑肌细胞中。 Ref 20, p 26A,B Slides 14 这个研究是不同程度哮喘患者(n=26)痰液中的白三烯水平与正常对照组(n=10)进行比较。 结果显示哮喘患者痰液中中位白三烯的浓度显著高于正常对照组(p0