文档介绍：Slide1AdaptedfromNationalInstitutesofHealthGlobalInitiativeforAsthma:GlobalStrategyforAsthmaManagementandPrevention:-,MD:NationalInstitutesofHealth,1998;BjermerLRespirMed2001;95:703-,从而产生症状对轻中度哮喘病人应首先进行控制炎症的治疗Slide2抑制多种炎症介质细胞因子粘附分子可诱导的酶对炎性反应的多种作用AdaptedfromPeters-GoldenM,SampsonAPJAllergyClinImmunol2003;111(suppl1):S37-皮质激素的作用Slide3尽管使用了吸入激素,气道炎症仍持续存在ICS=inhaledcorticosteroids;OCS±ICS=receivedoralcorticosteroidswithorwithoutICSAdaptedfromLouisRetalAmJRespirCritCareMed2000;161:9-,00010,0001,000100101Eosinophil103/gsputumControlgroup轻到中度哮喘ICSlow-dose(n=10)ICShigh-dose(n=15)OCS(n=10)OCS±ICS(n=7)重度哮喘p<<<<=,Peters-GoldenMJAllergyClinImmunol2003;111(1suppl):S1-S4;HolgateSTetalJAllergyClinImmunol2003;111(1suppl):S18-S36;HendersonWRJretalAmJRespirCritCareMed2002;165:108-116;Peters-GoldenM,SampsonAPJAllergyClinImmunol2003;111(1suppl):S37-S42;VarnerAE,,UK:BlackwellScience,2000:1172-:在哮喘早期及疾病全程中的重要性Slide5炎症反应的双通道半胱氨酰白三烯受体的表达NeutrophilMonocyteMacrophageBasophilPluripotenthemopoieticR3CD4+CD8+CD19M-CSF,GM-CSF,IL-3LTC4,LTD4,LTE4LN5MastCellLTC4LTD4LTE4M-CSFGM-CSFIL-5IL-3GM-CSFLTC4LTD4LTE4CD14IL5RβRepresentstheCysLT1receptorAdaptedfromFigueroaDJetalAmJRespirCritCareMed2001;163:226-233;atlAcadSciUSA2001;98:7964-7969CysLT1RCD34+Slide6炎症反应的双通道半胱氨酰白三烯在炎性细胞受体上的作用嗜酸细胞肺巨噬细胞Smooth-musclecellB淋巴细胞CysLT=cysteinylleukotriene;PBMC=peripheralbloodmononuclearcellsAdaptedfromFigueroaDJetalAmJRespirCritCareMed2001;163:226--GoldenM,SampsonAPJAllergyClinImmunol2003;111(suppl1):S37-白三烯是强大的炎症介质其它介质受体其它介质光胱氨酰白三烯受体光胱氨酰白三烯Slide8AdaptedfromHayDWPetalTrendsPharmacolSci1995;16:304-(肥大细胞,嗜酸性细胞)感觉神经(C纤维)CysLTs水肿血管粘液转运减少嗜酸性细胞内流阳离子蛋白释放,上皮细胞损伤收缩和增生气道平滑肌粘液分泌增多气道上皮炎症反应的双通道