tailieunhanh - Báo cáo y học: "Asthma: Eosinophil Disease, Mast Cell Disease, or Both"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Asthma: Eosinophil Disease, Mast Cell Disease, or Both? | ORIGINAL ARTICLE Asthma Eosinophil Disease Mast Cell Disease or Both Peter Bradding DM FRCP Although there is much circumstantial evidence implicating eosinophils as major orchestrators in the pathophysiology of asthma recent studies have cast doubt on their importance. Not only does anti-interleukin-5 treatment not alter the course of the disease but some patients with asthma do not have eosinophils in their airways whereas patients with eosinophilic bronchitis exhibit a florid tissue eosinophilia but do not have asthma. In contrast mast cells are found in all airways and localize specifically to key tissue structures such as the submucosal glands and airway smooth muscle within asthmatic bronchi irrespective of disease severity or phenotype. Here they are activated and interact exclusively with these structural cells via adhesive pathways and through the release of soluble mediators acting across the distance of only a few microns. The location of mast cells within the airway smooth muscle bundles seems particularly important for the development and propagation of asthma perhaps occurring in response to and then serving to aggravate an underlying abnormality in asthmatic airway smooth muscle function. Targeting this mast cell-airway smooth muscle interaction in asthma offers exciting prospects for the treatment of this common disease. Key words asthma eosinophil mast cell Asthma Immunopathology Asthma is a complex immunologic and inflammatory disease characterized by the presence of airway inflammation airway wall remodelling and bronchial hyperresponsiveness BHR . Exactly how these three features interact and whether they are dependent on each other for their occurrence is not clear. Although this article focuses on the role of mast cells and eosinophils in asthma pathogenesis it is important to appreciate that most if not all elements of the asthmatic airway are dysfunctional. There is epithelial damage with failure of healing and overproduction of growth .