变应性鼻炎重塑及相关因子研究.docVIP

变应性鼻炎重塑及相关因子研究 　　[摘要] 变应性鼻炎与支气管哮喘均属于呼吸道炎症疾病，由IgE介导、嗜酸粒细胞数量在气道显著增加为其病理生理特点，两者有相似且交叉的发病机制及临床治疗，流行病学上两者的发病率密切相关，基于“同一气道、同一疾病”的观点，在支气管哮喘重塑研究的基础上，变应性鼻炎是否存在重塑尚有争议，本文总结变应性鼻炎在流行病学上与哮喘的关系，鼻黏膜在变应原长期刺激下的重塑（包括上皮细胞、基底膜厚度、血管及黏液腺的改变）及在重塑研究中可能起重要作用的细胞因子，更加全面且深入地研究变应性鼻炎，旨在为临床治疗变应性鼻炎提供一条新策略及途径。 　　[关键词] 变应性鼻炎；重塑；支气管哮喘 　　[中图分类号] R765.21 [文献标识码] A [文章编号] 1673-7210（2016）11（c）-0043-05 　　Research on remodeling and related factors of allergic rhinitis 　　ZHANG Qingping XU Yu 　　Department of Otolaryngology Head and Neck Surgery， Renmin Hospital of Wuhan University， Hubei Province， Wuhan 430060， China 　　[Abstract] Allergic rhinitis and bronchial asthma are respiratory inflammatory diseases mediated by IgE， the number of eosinophils in the airway was significantly increased as the pathological and physiological characteristics， the two have similar and cross the pathogenesis and clinical treatment， epidemiological study on the incidence of the two closely linked，based on the one airway， one disease point of view， the study of remodeling on bronchial asthma is comprehensive， allergic rhinitis remodeling remains controversial， this article aims to summarize the relationship between allergic rhinitis and asthma in the epidemiology， remodeling of the nasal mucosa in long-term allergen stimulated （including epithelial cells， basement membrane thickness， vascular and glandulae mucosa changes） and the cytokines may play an important role in the remodeling of the nasal mucosa， more comprehensive and in-depth study of allergic rhinitis， and provide a new strategy and approach for the treatment of allergic rhinitis. 　　[Key words] Allergic rhinitis； Remodeling； Bronchial asthma 　　?应性鼻炎（allergic rhinitis，AR）和支气管哮喘（bronchial asthma，BA）均属于气道变应性疾病，在致敏原的刺激下Th1/Th2 CD4+细胞分化偏倚Th2 CD4+细胞，以IgE介导、嗜酸粒细胞浸润为主要特征，肥大细胞、T淋巴细胞、嗜碱粒细胞等多种炎性细胞及其分泌的细胞因子（IL-4、IL-5、IL-6、IFN-r、TNF-α等）参与的呼吸道慢性变应性炎症疾病。哮喘，为变应性炎症引起的下气道病变，气道长期处于修复和重塑的动态平衡状态，最终导致气道不可逆性缩窄，并发老年慢性支气管炎、肺气肿、肺心病等严重疾患。在哮喘气道黏膜组织重塑的基础研究上学者们把目光放在了AR鼻黏膜是否可能和下呼吸道相似存在组织重塑