[1]魏艳,刘芬,程欣,等.噻托溴铵联合布地奈德福莫特罗对中度哮喘患者β2受体的调节作用[J].第三军医大学学报,2013,35(11):1152-1155.
 Wei Yan,Liu Fen,Cheng Xin,et al.Tiotropium combined with budesonide formoterol regulates β2 receptor in moderate asthma patients: report of 84 cases[J].J Third Mil Med Univ,2013,35(11):1152-1155.
点击复制

噻托溴铵联合布地奈德福莫特罗对中度哮喘患者β2受体的调节作用(/HTML )
分享到:

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
35卷
期数:
2013年第11期
页码:
1152-1155
栏目:
论著
出版日期:
2013-06-15

文章信息/Info

Title:
Tiotropium combined with budesonide formoterol regulates β2 receptor in moderate asthma patients: report of 84 cases
作者:
魏艳刘芬程欣刘春涛
四川大学华西医院:临床药物试验中心,呼吸内科; 滕州市中心人民医院呼吸内科
Author(s):
Wei Yan Liu Fen Cheng Xin Liu Chuntao
Center of Clinical Drug Trial, Department of Respiratory Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041; Department of Respiratory Diseases, Tengzhou Central Hospital, Tengzhou, Shandong Province, 277500, China
关键词:
支气管哮喘 布地奈德福莫特罗 噻托溴铵肾上腺素能受体 胆碱能受体
Keywords:
bronchial asthma budesonide formoterol tiotropium adrenergic receptor cholinergic receptor
分类号:
R562.25;R974.3;R977.11
文献标志码:
A
摘要:
目的      观察联合应用吸入性糖皮质激素/长效β2受体激动剂(inhaled corticosteroid/long-acting β2 agonist,ICS/ LABA)和长效抗胆碱能拮抗剂(long-acting antimuscarinic agent,LAMA)对中度哮喘患者外周血淋巴细胞β2R的调节作用及意义。      方法        将初治中度持续性哮喘患者分为ICS/LABA组和ICS/LABA+LAMA组,给药前后测定肺功能、ACT评分及AQLQ评分,Western blot检测外周血淋巴细胞β2受体、M3受体、PLCβ1水平。      结果      84例患者给药24周时2组FEV1值、ACT评分、AQLQ评分均有明显提高,且ICS/LABA+LAMA组较ICS/LABA组改善更为显著 (P<0.05)。Western blot检测结果显示,治疗24周后ICS/LABA组外周血淋巴细胞较治疗前β2AR水平略有下降(P>0.05); ICS/LABA+LAMA组外周血淋巴细胞β2AR水平较治疗前变化不大(P>0.05);ICS/LABA组外周血淋巴细胞M3R、PLCβ1蛋白表达水平较治疗前逐渐升高(P<0.05);ICS/LABA+LAMA组M3R、PLCβ1蛋白表达水平较治疗前明显降低(P<0.05)。      结论        β2受体激动剂的长期使用使哮喘患者出现气道高反应性增高、支气管保护效应下降、急性发作次数增加和病死率上升的现象,可能与M3R及其通路的活化/表达上调和β2受体出现脱敏有关,联合LAMA通过拮抗M3R有可能恢复对β2受体激动剂的敏感性,从而抵消由于β2受体脱敏和M3R及其通路活化引起的不良反应。
Abstract:
Objective       To investigate the role of the combination of inhaled corticosteroid/long-acting β2 agonist (ICS/LABA) and long-acting anti-cholinergic drugs (LAMA) in regulation of peripheral blood lymphocytes from patients with moderate asthma.       Methods       A total of 84 moderate persistent asthma outpatients (with asthma over 1 year, 40%≤FEV1%≤60%) in the department of respiratory diseases, West China Hospital during November 2010 to December 2011 were randomly and equally divided into ICS/LABA group and ICS/LABA+LAMA group. Pulmonary function, asthma control test (ACT) score and asthma quality of life questionnaire (AQLQ) score were measured before and after administration. Western blotting was used to analyze β2 receptor, M3 receptor and PLCβ1 in peripheral blood lymphocytes.       Results       The FEV1 value, ACT score, and AQLQ score of the 84 patients were significantly improved after 24 weeks’ administering in both groups. Meanwhile, ICS/LABA/LAMA group improved more significantly (P<0.05 in all). β2AR decreasing trend in ICS/LABA group was not obvious, the protein expression of M3R and PLCβ1 was increased, and in ICS/LABA/LAMA group, β2AR level was unchanged the M3R was significantly decreased, and PLCβ1 was noticeably increased.       Conclusion       Long-term administration of β2 agonists may lead to the increased airway hyper-responsiveness, reduce bronchial protection effect, increase risks for acute exacerbation, and higher incidence of mortality. This phenomenon may be related to the activation or up-regulation of M3R and its pathway and desensitization of β2 receptors. Combining with LAMA, the sensitivity of β2 agonists might restore the antagonizing M3R, which therefore offset the adverse reactions caused by the desensitization of β2 receptor, as well as activation of M3R and its pathway.

参考文献/References:

魏艳, 刘芬, 程欣, 等. 噻托溴铵联合布地奈德福莫特罗对中度哮喘患者β2受体的调节作用[J].第三军医大学学报,2013,35(11):1152-1155.

相似文献/References:

[1]麻晓燕,罗雅玲,赖文岩,等.支气管哮喘患者外周血、痰液中IL-33的含量及其相关性分析[J].第三军医大学学报,2011,33(14):1526.
 Ma Xiaoyan,Luo Yaling,Lai Wenyan,et al.IL-33 levels in peripheral blood plasma and sputum of patients with bronchial asthma and their correlation with symptoms of patients, pulmonary function, and eosinophil numbers[J].J Third Mil Med Univ,2011,33(11):1526.
[2]秦光梅,江兵,杨时光,等.急性重症支气管哮喘并气胸无创通气治疗的临床评价[J].第三军医大学学报,2006,28(08):854.
[3]刘荣胜,易斌.术中立止血静注致哮喘1例[J].第三军医大学学报,2005,27(13):1341.
[4]陈立东,杨文东.支气管哮喘患儿血清可溶性细胞间粘附分子-1和E-选择素水平变化及其价值[J].第三军医大学学报,2005,27(20):2072.
[5]张旭升,邹利光,白莉,等.哮喘与慢性阻塞性肺疾病支气管改变的HRCT定量研究[J].第三军医大学学报,2011,33(06):611.
 Zhang Xusheng,Zou Liguang,Bai Li,et al.Bronchial changes in asthma and chronic obstructive pulmonary disease: a quantitative study by high resolution computed tomography[J].J Third Mil Med Univ,2011,33(11):611.
[6]王莹,黄英,赵京.初诊哮喘儿童骨密度的变化及意义[J].第三军医大学学报,2011,33(24):2600.
 Wang Ying,Huang Ying,Zhao Jing.Changes and significance of bone mineral density in children with newly diagnosed asthma[J].J Third Mil Med Univ,2011,33(11):2600.
[7]胡琦,钟世民,汪金玉,等.皮下注射大剂量卵白蛋白诱导小鼠哮喘免疫耐受模型的建立及机制初步研究[J].第三军医大学学报,2016,38(12):1404.
 Hu Qi,Zhong Shimin,Wang Jinyu,et al.Establishment of mouse model of immune tolerance of asthma through subcutaneous injection of high dose of ovalbumin[J].J Third Mil Med Univ,2016,38(11):1404.
[8]周丽蓉,张劼,罗永艾.IDO与Treg在支气管哮喘小鼠中的相互作用及其意义[J].第三军医大学学报,2013,35(13):1384.
 Zhou Lirong,Zhang Jie,Lou Yongai.Interaction of indoleamine 2, 3-dioxygenase and CD4+CD25+Foxp3+ regulatory T cell in asthmatic mice[J].J Third Mil Med Univ,2013,35(11):1384.
[9]朱婧,夏俊波,王娇莉,等.孕鼠补充1α,25-二羟维生素D3水平对仔鼠变应性气道炎症的影响[J].第三军医大学学报,2013,35(22):2452.
 Zhu Jing,Xia Junbo,Wang Jiaoli,et al.Effect of maternal 1α,25-dihydroxyvitamin D3 supplement on allergic airway inflammation of its offspring in mouse asthma model[J].J Third Mil Med Univ,2013,35(11):2452.
[10]李莹,张巧,万敏,等.门诊支气管哮喘患者合并焦虑、抑郁情绪分析[J].第三军医大学学报,2011,33(19):2085.
 Li Ying,Zhang Qiao,Wan Min,et al.Analysis of anxiety and depression in asthma outpatients[J].J Third Mil Med Univ,2011,33(11):2085.

更新日期/Last Update: 2013-06-03