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Targeting systemic inflammation: novel therapies for the treatment of chronic obstructive pulmonary disease.

机译:靶向全身性炎症:用于治疗慢性阻塞性肺疾病的新疗法。

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摘要

The increasing evidence that inflammation in the lungs leads to the structural changes observed in chronic obstructive pulmonary disease, whereas extrapulmonary symptoms and comorbidities may be systemic manifestations of these inflammatory processes, highlights an urgent need to discover novel, effective anti-inflammatory treatments for this disease. Some studies are suggesting that, by decreasing dynamic hyperinflation, bronchodilators might reduce systemic inflammation; inhaled corticosteroids and their combination with long-acting beta2-agonists might contribute to this goal. Even so, the opinion that suppression of the inflammatory response might improve systemic complications is stimulating a search for novel anti-inflammatory therapies. Many drugs include those that inhibit the recruitment and activation of inflammatory cells and/or antagonise their products. However, many of these therapeutic strategies are not specific for neutrophilic inflammation because they affect other cell types, thus, it is difficult to interpret whether any clinical benefit observed is a result of a reduction in airway neutrophils. In any case, there is some evidence that drugs used to treat a co-morbid condition, such as statins, angiotensin converting enzyme (ACE) inhibitors and angiontensin II type 1 (AT1) receptor blockers as well as glycosaminoglycans and peroxisome proliferator-activated receptor (PPAR) agonists, might benefit chronic obstructive pulmonary disease patients because they deal with the extrapulmonary, systemic component of chronic obstructive pulmonary disease.
机译:越来越多的证据表明,肺部炎症会导致慢性阻塞性肺疾病中观察到的结构变化,而肺外症状和合并症可能是这些炎症过程的系统性表现,这凸显了迫切需要找到针对这种疾病的新颖有效的抗炎治疗方法。一些研究表明,通过减少动态过度充气,支气管扩张剂可以减轻全身性炎症。吸入糖皮质激素及其与长效β2受体激动剂的结合可能有助于实现这一目标。即便如此,抑制炎症反应可能会改善全身并发症的观点正在刺激寻找新的抗炎疗法。许多药物包括抑制炎症细胞募集和活化和/或拮抗其产品的药物。然而,这些治疗策略中的许多对嗜中性粒细胞炎症不是特异性的,因为它们影响其他细胞类型,因此,难以解释观察到的任何临床益处是否是气道嗜中性粒细胞减少的结果。无论如何,有证据表明,用于治疗合并症的药物,例如他汀类药物,血管紧张素转换酶(ACE)抑制剂和血管紧张素II 1型(AT1)受体阻滞剂以及糖胺聚糖和过氧化物酶体增殖物激活受体(PPAR)激动剂可能会使慢性阻塞性肺疾病患者受益,因为它们可以治疗慢性阻塞性肺疾病的肺外,全身性成分。

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