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Abnormal corticosteroid signalling in airway smooth muscle: mechanisms and perspectives for the treatment of severe asthma

机译：气道平滑肌中糖皮质激素异常信号转导：治疗严重哮喘的机制和观点

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摘要

Growing invivo evidence supports the concept that airway smooth muscle produces various immunomodulatory factors that could contribute to asthma pathogenesis via the regulation of airway inflammation, airway narrowing and remodelling. Targeting ASM using bronchial thermoplasty has provided undeniable clinical benefits for patients with uncontrolled severe asthma who are refractory to glucocorticoid therapy. The present review will explain why the failure of glucocorticoids to adequately manage patients with severe asthma could derive from their inability to affect the immunomodulatory potential of ASM. We will support the view that ASM sensitivity to glucocorticoid therapy can be blunted in severe asthma and will describe some of the factors and mechanisms that could be responsible for glucocorticoid insensitivity.
机译：越来越多的体内证据支持以下观点：气道平滑肌会产生各种免疫调节因子，这些因子可能通过调节气道炎症，气道变窄和重塑而导致哮喘发病。使用支气管热成形术靶向ASM已为糖皮质激素治疗难以治疗的无法控制的严重哮喘患者提供了不可否认的临床益处。本综述将解释为什么糖皮质激素不能充分控制重度哮喘患者的失败可能源于他们无法影响ASM的免疫调节潜力。我们将支持这样的观点，即在严重的哮喘中ASM对糖皮质激素治疗的敏感性可能会减弱，并将描述可能导致糖皮质激素敏感性下降的一些因素和机制。

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