维生素D辅助治疗过敏性哮喘的研究进展

过敏性哮喘是由多种炎症细胞和介质共同参与的以气道炎症为特征的疾病,病因和发病机制极其复杂,目前尚不完全清楚。维生素D最经典的作用是调节钙和磷的吸收,近年来随着对维生素D代谢和生物学效应的深入研究,发现维生素D对人体免疫系统存在更广泛的影响,在大多数疾病中均能发挥作用。维生素D参与哮喘辅助治疗的机制体现在多个方面,主要通过免疫学机制调节Th1/Th2平衡,降低气道重塑的风险。此外,维生素D能影响肠道菌群组成和比例,可能通过“肺—肠轴”缓解哮喘。在此基础上,维生素D与糖皮质激素等药物联用,可以增强药效,减少药物用量。本文就维生素D辅助治疗过敏性哮喘的研究进展进行总结分析。     

气道上皮细胞在哮喘中的作用

随着现代医学的发展,人们对支气管哮喘发病机制的研究有了进一步发展.支气管哮喘(简称哮喘)是一种由多种细胞,多种细胞因子参与形成的慢性气道炎症性疾病.支气管上皮细胞是气道结构细胞,它是抵抗外界损伤因素的第一道防线,当吸人性刺激物质时,首先激化支气管上皮细胞并破坏支气管上皮细胞的正常结构和生理功能,在应激状态下的上皮细胞通过分泌炎性介质与自身细胞或其他气道结构细胞、炎性细胞、抗原递呈细胞等相互作用,积极参与哮喘的气道慢性炎症发生与发展进程.因此气道上皮损伤是影响哮喘发生发展的重要因素,阐明维持气道上皮正常结构和功能的分子机制是目前防治哮喘的重要课题.本文综述气道上皮在哮喘发生发展中的作用及相关机制研究进展.     

诱发支气管哮喘动物模型气道重塑特征的方法和评价

气道重塑是慢性哮喘最复杂的病理基础之一,建立具有气道重塑特征的支气管哮喘动物模型对评价药效及阐明病理机制的研究具有重要的意义.通过对相关动物模型进行分析比较,总结可行的支气管哮喘气道重塑动物模型构建方法.     

基因编辑动物模型在人类疾病研究中的应用

近年来,随着以CRISPR/Cas9为代表的多种CRISPR系统的开发和不断改进,基因编辑技术逐渐完善,并广泛应用于人类疾病动物模型的制备。基因编辑动物模型为人类疾病的发病机理、病理过程以及预防和治疗等方面的研究提供了重要的素材。目前,用于人类疾病研究的基因编辑动物模型主要有小鼠、大鼠为代表的啮齿类动物模型和以猪为代表的大动物模型。其中啮齿类动物在机体各方面与人类差别较大,且寿命短,无法对人类疾病的研究和治疗提供有效评估和长期追踪;而猪在生理学、解剖学、营养学和遗传学等各方面与人类更接近,是器官移植和人类疾病研究领域重要的动物模型。文中主要介绍了基因编辑动物模型在神经退行性疾病、肥厚心肌病、癌症、免疫缺陷类疾病和代谢性疾病等5种人类疾病研究中的应用情况,以期为人类疾病研究及相关动物模型的制备提供参考。     

阿尔茨海默病转基因小鼠的特点和应用

建立动物模型的目的是在实验动物身上复制人类疾病的模型,用于研究人类疾病的病因、发病、病理变化以及疾病的预防和治疗。目前尚无理想的阿尔茨海默病（Alzheimer’s disease,AD）动物模型,AD实验动物模型的滞后在很大程度上制约了AD治疗药物的筛选。随着AD病因和发病机制研究的不断深入,更完善的AD动物模型也在陆续出现。近年来出现的转基因动物模型属于AD的病因模型,但也不能完整复制出AD的所有特征。最大的缺憾在于缺乏神经原纤维缠结（neurofibrillary tangles,NFTs）和在某些转基因模型中（尤其是单转基因模型）无广泛的神经元丢失。虽然用免疫组化方法检测到tau蛋白,但从未发现成对螺旋纤丝（paired helical filaments,PHF）。     

通光散汤对小鼠哮喘模型气道高反应性和气道炎症的影响

目的观察通光散对小鼠哮喘模型气道反应和气道炎症的影响。方法35只6周龄BALB／c小鼠随机分为哮喘模型组、正常对照组和药物实验组。模型组和药物组以鸡卵白蛋白（OVA）致敏、激发;药物组在最后一次致敏后每天灌胃给予通光散汤0．72mL（相当于0．04g生药）;对照组以等体积的Ns代替OVA致敏、激发。末次激发48h后处理小鼠：无创法测定小鼠的气道高反应性,观察气道阻力变化;支气管肺泡灌洗液（BALF）行细胞学分类;观察肺组织的病理变化。结果①药物组小鼠气道阻力的变化与模型组相比明显下降,差异显著（P＜0．05）;②药物组BALF白细胞总数和Eos（％）与模型组相比明显降低（P＜0．05）。③模型组小鼠肺脏组织支气管、血管黏膜下和周围肺组织有明显的炎症细胞浸润,大量炎症细胞向支气管和血管迁移,上皮细胞部分有脱落,部分可见黏液栓,血管壁明显水肿;治疗组小鼠肺组织炎性细胞浸润和管腔黏液分泌情况较模型组明显减轻,气道粘液的分泌量得到明显的控制。结论通光散汤对小鼠哮喘模型气道高反应性和气道炎症有显著抑制作用。     

肺部菌群对过敏性哮喘的影响CSCD

过敏性哮喘是一种常见的过敏性疾病,其发病机制尚未完全清楚,但共生微生物与宿主免疫稳态的建立及维持关系密切。近年来的研究发现肠道菌群在过敏性哮喘的发生发展中起主要作用,“肺-肠轴”概念的提出阐释了肺部菌群与肠道菌群之间的串扰关系。研究证实肺部菌群与过敏性哮喘密切相关,并通过肺-肠轴直接或间接影响过敏性哮喘的发生发展。本文分析肺部菌群与过敏性哮喘的相关性及可能的机制,深入了解肺部菌群在过敏性哮喘中的作用及意义,以期为过敏性哮喘的临床预防及诊疗拓宽思路。     

非人灵长类糖尿病动物模型研究进展

糖尿病是继心血管疾病和肿瘤之后的另一种严重危害人类健康的重要慢性疾病,据世界卫生组织(WHO)报道,2009年全世界约有2.2亿糖尿病患者。对糖尿病发病机理的研究、预防和诊断、治疗药物的筛选和评价都需要合适的动物模型。在已报道的糖尿病动物模型中,非人灵长类动物糖尿病病程、病症与人类的糖尿病最为相似。该文从糖尿病动物模型的来源归纳了目前报道的主要的非人灵长类糖尿病模型,重点介绍了猕猴、食蟹猴和树鼩糖尿病模型及其特征,并对该领域的发展提出了一些思考。     

真菌过敏性哮喘的治疗研究进展

真菌过敏性哮喘是由环境中真菌致敏原暴露诱导的一种呼吸道慢性炎症性疾病。真菌过敏哮喘患者肺部炎症细胞、结构细胞及细胞组分间有复杂的相互作用,使得患者气道壁重塑并伴渐进性肺功能障碍,表现为喘息、胸闷、呼吸困难等症状,对患者的工作和生活造成严重影响,而目前糖皮质激素及抗菌药物等传统疗法对其治疗效果欠佳。近年来,很多研究开始致力于对真菌过敏性哮喘新的治疗方法进行积极探索,使得真菌过敏性哮喘的治疗除应用糖皮质激素等传统方法外,在抗真菌感染及其免疫学治疗控制真菌过敏性哮喘方面取得一定新进展。     

人干细胞实验动物嵌合体模型的研究进展

动物模型是疾病研究、发病机制、药物治疗的必要工具,目前一些困扰人类健康的重大疾病如艾滋病、乙型肝炎等因为还没有能反映人类疾病发病机理的理想动物模型。人干细胞是能在体外长期培养的、高度未分化的全能细胞系,亚全能细胞系和分化的干细胞等。如果能将人的干细胞成功移植入实验动物体内形成人源化嵌合体动物,有希望为艾滋病、肝炎等的研究制备适当的模型。人类干细胞在动物中的移植研究中主要的实验动物是绵羊,小鼠等,本文介绍了人干细胞在动物体内移植的研究进展。     

哮喘气道重塑大鼠气道上皮细胞及线粒体超微结构变化

目的探讨哮喘气道重塑大鼠气道上皮细线粒体超微结构变化,为哮喘的治疗寻求新的理论基础。方法雌性Wistar大鼠6只、随机分为2组,采用卵蛋白吸人法制作哮喘气道重塑大鼠模型;取两组大鼠气管制作电镜切片,观察两组大鼠气道纤毛上皮,气道上皮细胞问胶原沉积及细胞内线粒体超微结构改变。结果哮喘组大鼠气道多层纤毛上皮层,纤毛脱落,杯状细胞增多,排列不整齐,上皮细胞中线粒体基膜密度下降,线粒体峡减少,上皮细胞细胞核多切迹,形状不规则;气道上皮细胞间胶原沉积;板层小体和线粒体空泡化。结论哮喘大鼠气道上皮细胞出现早期凋亡改变,线粒体失去正常形态。     

Role of Abl in airway hyperresponsiveness and airway remodeling

Background

Asthma is a chronic disease that is characterized by airway hyperresponsiveness and airway remodeling. The underlying mechanisms that mediate the pathological processes are not fully understood. Abl is a non-receptor protein tyrosine kinase that has a role in the regulation of smooth muscle contraction and smooth muscle cell proliferation in vitro. The role of Abl in airway hyperresponsiveness and airway remodeling in vivo is largely unknown.

Methods

To evaluate the role of Abl in asthma pathology, we assessed the expression of Abl in airway tissues from the ovalbumin sensitized and challenged mouse model, and human asthmatic airway smooth muscle cells. In addition, we generated conditional knockout mice in which Abl expression in smooth muscle was disrupted, and then evaluated the effects of Abl conditional knockout on airway resistance, smooth muscle mass, cell proliferation, IL-13 and CCL2 in the mouse model of asthma. Furthermore, we determined the effects of the Abl pharmacological inhibitors imatinib and GNF-5 on these processes in the animal model of asthma.

Results

The expression of Abl was upregulated in airway tissues of the animal model of asthma and in airway smooth muscle cells of patients with severe asthma. Conditional knockout of Abl attenuated airway resistance, smooth muscle mass and staining of proliferating cell nuclear antigen in the airway of mice sensitized and challenged with ovalbumin. Interestingly, conditional knockout of Abl did not affect the levels of IL-13 and CCL2 in bronchoalveolar lavage fluid of animals treated with ovalbumin. However, treatment with imatinib and GNF-5 inhibited the ovalbumin-induced increase in IL-13 and CCL2 as well as airway resistance and smooth muscle growth in animals.

Conclusions

These results suggest that the altered expression of Abl in airway smooth muscle may play a critical role in the development of airway hyperresponsiveness and airway remodeling in asthma. Our findings support the concept that Abl may be a novel target for the development of new therapy to treat asthma.     

ERK活化对哮喘大鼠气道重塑及CyclinD1表达的影响

目的探讨细胞外信号调节蛋白激酶（ERK）对哮喘大鼠气道重塑及CyclinD1表达的作用。方法原代培养大鼠的平滑肌细胞（ASMCs）,给予ERK激动剂表皮生长因子EGF和抑制剂PD98059干预ASMCs生长,依处理方式不同分为5组：（1）正常对照组（2）哮喘对照组;（3）E组：EGF20 ng/mL;（4）P＋E组,PD98059 10μmol/L1 h后添加EGF 20 ng/mL;（5）PD组,PD98059 10μmol/L。采用四甲基偶氮唑盐（MTT）法检测气道平滑肌细胞（ASMCs）增殖能力,流式细胞术（FCM）测定细胞周期和cyclinD1的蛋白含量,RT-PCR方法检测cyclinD1mRNA表达水平。结果（1）与哮喘对照组比较,E组ASMCs S＋G2/M期比例、吸光度A值、cyclinD1蛋白阳性表达率和cyclinD1 mRNA的A值均显著升高,PD组均显著降低（P〈0.05）。P＋E组与哮喘对照在此4项指标上比较无明显差异。（2）哮喘（对照组、E组、PD组和P＋E组）组与正常对照组,其S＋G2/M期比例、吸光度A值、cyclinD1蛋白和cyclinD1 mRNA的表达均显著增高（P〈0.05）。结论ERK活性促进哮喘大鼠ASMCs的增殖,增加cyclinD1在哮喘平滑肌细胞中的表达,导致气道重塑的形成,提示ERK可能对CyclinD1的表达具有调节作用。     

IL-19对哮喘模型大鼠气道平滑肌细胞增殖的影响

目的探讨IL-19对哮喘大鼠气道平滑肌细胞（ASMCs）增殖的作用。方法通过对大鼠进行雾化卵清蛋白,制备哮喘模型大鼠。提取哮喘大鼠ASMCs进行培养,分别以1μg/L、10μg/L、100μg/L IL-19干预ASMCs生长。采用流式细胞仪、MTT法检测ASMCs增殖情况,观察不同浓度IL-19对ASMCs增殖的影响。结果与正常鼠相比,慢性哮喘大鼠ASMCs增殖明显,处于S期的细胞比例明显增高。经10μg/L、100μg/L IL-19干预后,慢性哮喘大鼠ASMCs处于S期的细胞比例减少,增殖亦减弱。且两组间比较有明显差异。而经1μg/L IL-19干预后,慢性哮喘大鼠ASMCs处于S期的细胞比例及增殖均无明显变化。结论一定浓度的IL-19可能抑制慢性哮喘大鼠ASMCs的增殖。     

Airway house dust extract exposures modify allergen-induced airway hypersensitivity responses by TLR4-dependent and independent pathways

TLR ligands and other allergen-nonspecific immunostimulatory molecules are ubiquitous in ambient air and have profound modulatory activities in animal models of allergic asthma. However, several of these molecules have been shown to promote exaggerated Th2-biased airway hypersensitivity responses (AHRs), whereas others attenuate the asthmatic phenotype. Therefore, it has proven difficult to extrapolate experimental results with purified molecules toward a more general understanding of the allergen-nonspecific immunomodulatory influence of living environments on the natural history of allergic asthma. These investigations determined how regular and intermittent airway exposures to an unpurified, but sterile house dust extract standard (HDEst) affected the OVA-specific AHR and immune status of previously Th2-sensitized mice. Low-dose daily and high-dose intermittent HDEst exposures modulated ongoing AHRs considerably, reducing eosinophil recruitment and methacholine responsiveness, while increasing neutrophilic inflammation. However, only daily airway delivery of low-dose HDEst attenuated OVA-specific Th2 cytokine production and Th2-biased AHRs to allergen challenge 1 mo later. Finally, whereas LPS mimicked many of the immunomodulatory characteristics of HDEst in this murine asthma model, daily airway HDEst delivery was highly effective in attenuating the AHR of OVA/alum-sensitized TLR4-deficient mice. Taken together, these investigations provide direct evidence that living environments contain allergen-nonspecific immunostimulatory molecules that influence the airway hypersensitivity status of allergen-sensitized mice by TLR4-dependent and independent mechanisms.     

Protective effect of resolvin E1 on the development of asthmatic airway inflammation

Resolvin E1 (RvE1) is an anti-inflammatory lipid mediator derived from the omega-3 fatty acid eicosapentaenoic acid (EPA), and strongly acts in the resolution of inflammation. We previously reported that RvE1 dampens airway inflammation and hyperresponsiveness in a murine model of asthma. In the present study, to elucidate the effects of RvE1 on the development of asthmatic airway inflammation, we investigated whether RvE1 acts on different phases of an OVA-sensitized and -challenged mouse model of asthma. RvE1 treatments at the time of either OVA sensitization or at the time of OVA challenge were investigated and compared with RvE1 treatments at the time of both OVA sensitization and challenge. After RvE1 was administered to mice intraperitoneally at the time of both OVA sensitization and challenge, there were decreases in airway eosinophil and lymphocyte recruitment, as well as a reduction in Th2 cytokine and airway hyperresponsiveness. RvE1 treatment at the time of either OVA sensitization or challenge also improved AHR and airway inflammation. Our results suggest that RvE1 acts on several phases of asthmatic inflammation and may have anti-inflammatory effects on various cell types.     

Airway wall remodeling: friend or foe?

Airway wall remodeling is well documented for asthmatic airways and is believed to result from chronic and/or short-term exposure to inflammatory stimuli. Airway wall remodeling can contribute to airway narrowing as well as to the airway hyperresponsiveness, which is a characteristic abnormality in asthma. However, the potential for airway narrowing could be much worse if it were not for some of the protective effects of remodeling that may help to limit airway narrowing in asthmatic patients. This minireview discusses the evidence for airway wall remodeling and its effects, friend and/or foe, on airway narrowing in asthmatic patients.     

Tumstatin regulates the angiogenic and inflammatory potential of airway smooth muscle extracellular matrix

The extracellular matrix (ECM) creates the microenvironment of the tissue; an altered ECM in the asthmatic airway may be central in airway inflammation and remodelling. Tumstatin is a collagen IV‐derived matrikine reduced in the asthmatic airway wall that reverses airway inflammation and remodelling in small and large animal models of asthma. This study hypothesized that the mechanisms underlying the broad asthma‐resolving effects of tumstatin were due to autocrine remodelling of the ECM. Neutrophils and endothelial cells were seeded on decellularized ECM of non‐asthmatic (NA) or asthmatic (A) airway smooth muscle (ASM) cells previously exposed to tumstatin in the presence or absence of a broad matrix metalloproteinase inhibitor, Marimastat. Gene expression in NA and A ASM induced by tumstatin was assessed using RT‐PCR arrays. The presence of tumstatin during ECM deposition affected neutrophil and endothelial cell properties on both NA and A ASM‐derived matrices and this was only partly due to MMP activity. Gene expression patterns in response to tumstatin in NA and A ASM cells were different. Tumstatin may foster an anti‐inflammatory and anti‐angiogenic microenvironment by modifying ASM‐derived ECM. Further work is required to examine whether restoring tumstatin levels in the asthmatic airway represents a potential novel therapeutic approach.     

Airway remodeling in asthma amplifies heterogeneities in smooth muscle shortening causing hyperresponsiveness.

Although airway remodeling and inflammation in asthma can amplify the constriction response of a single airway, their influence on the structural changes in the whole airway network is unknown. We present a morphometric model of the human lung that incorporates cross-sectional wall areas corresponding to the adventitia, airway smooth muscle (ASM), and mucosa for healthy and mildly and severely asthmatic airways and the influence of parenchymal tethering. A heterogeneous ASM percent shortening stimulus is imposed, causing distinct constriction patterns for healthy and asthmatic airways. We calculate lung resistance and elastance from 0.1 to 5 Hz. We show that, for a given ASM stimulus, the distribution of wall area in asthmatic subjects will amplify not only the mean but the heterogeneity of constriction in the lung periphery. Moreover, heterogeneous ASM shortening that would produce only mild changes in the healthy lung can cause hyperresponsive changes in lung resistance and elastance at typical breathing rates in the asthmatic lung, even with relatively small increases in airway resistance. This condition arises when airway closures occur randomly in the lung periphery. We suggest that heterogeneity is a crucial determinant of hyperresponsiveness in asthma and that acute asthma is more a consequence of extensive airway wall inflammation and remodeling, predisposing the lung to produce an acute pattern of heterogeneous constriction.