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Mechanisms of airway hyper-responsiveness in asthma: the past, present and yet to come

机译:哮喘中气道高反应性的机制:过去,现在和将来

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摘要

Airway hyper-responsiveness (AHR) has long been considered a cardinal feature of asthma. The development of the measurement of AHR 40 years ago initiated many important contributions to our understanding of asthma and other airway diseases. However, our understanding of AHR in asthma remains complicated by the multitude of potential underlying mechanisms which in reality are likely to have different contributions amongst individual patients. Therefore, the present review will discuss the current state of understanding of the major mechanisms proposed to contribute to AHR and highlight the way in which AHR testing is beginning to highlight distinct abnormalities associated with clinically relevant patient populations. In doing so we aim to provide a foundation by which future research can begin to ascribe certain mechanisms to specific patterns of bronchoconstriction and subsequently match phenotypes of bronchoconstriction with clinical phenotypes. We believe that this approach is not only within our grasp but will lead to improved mechanistic understanding of asthma phenotypes and we hoped to better inform the development of phenotype-targeted therapy.
机译:长期以来,气道高反应性(AHR)被认为是哮喘的主要特征。 40年前AHR测量方法的发展为我们对哮喘和其他气道疾病的理解做出了许多重要贡献。但是,我们对哮喘中AHR的理解仍然由于众多潜在的潜在机制而变得复杂,实际上,这些潜在机制在各个患者之间可能会有不同的贡献。因此,本综述将讨论对提出有助于AHR的主要机制的理解现状,并强调AHR测试开始强调与临床相关患者群体相关的异常的方式。这样做的目的是为将来的研究提供依据,以便将某些机制归因于支气管收缩的特定模式,并随后将支气管收缩的表型与临床表型相匹配。我们相信这种方法不仅在我们的掌握之内,而且将导致对哮喘表型的更好的机械理解,并且我们希望更好地为表型靶向治疗的发展提供信息。

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