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1.北京中医药大学 生命科学学院,北京 100029
2.北京中医药大学 中医学院,北京 100029
3.北京中医药大学 东方医院,北京 100078
4.北京中医药大学 北京中医药研究院,北京 100029
5.国家中医药管理局 名医名方重点研究室,北京 100029
Received:18 November 2022,
Published Online:02 February 2023,
Published:05 March 2024
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杨涵,闫永煌,张文婷等.中医药调节免疫平衡治疗咳嗽变异性哮喘研究进展[J].中国实验方剂学杂志,2024,30(05):206-212.
YANG Han,YAN Yonghuang,ZHANG Wenting,et al.Regulation of Immune Balance by Traditional Chinese Medicine in Treatment of Cough Variant Asthma: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(05):206-212.
杨涵,闫永煌,张文婷等.中医药调节免疫平衡治疗咳嗽变异性哮喘研究进展[J].中国实验方剂学杂志,2024,30(05):206-212. DOI: 10.13422/j.cnki.syfjx.20230728.
YANG Han,YAN Yonghuang,ZHANG Wenting,et al.Regulation of Immune Balance by Traditional Chinese Medicine in Treatment of Cough Variant Asthma: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2024,30(05):206-212. DOI: 10.13422/j.cnki.syfjx.20230728.
咳嗽变异性哮喘(CVA)是以咳嗽为主要症状的慢性呼吸系统疾病。CVA的发生与非特异性气道炎症密切相关,发病机制涉及环境、遗传、免疫等因素。近年来,中医药在CVA治疗中的优势得到国内外专家学者的关注,尤其在调节免疫平衡缓解CVA患者咳嗽症状、减少复发次数等方面具有突出作用。辅助性T细胞(Th)1、Th2、Th17、调节性T细胞(Treg)由CD4
+
T细胞分化而来,Th1/Th2、Th17/Treg免疫失衡是CVA发病机制研究中的新热点,也是中医药治疗CVA的潜在关键靶标。Th细胞亚群生理情况下处于动态平衡,维持促炎细胞因子与抑炎细胞因子平衡的呼吸道免疫稳态。CVA发病阶段,未成熟的辅助T细胞(Th0)受微环境中细胞因子类型影响分化为Th1、Th2、Th17、Treg等细胞亚群,Th2细胞增殖引发嗜酸性粒细胞性气道炎症,Th17细胞过度分化诱发中性粒细胞性气道炎症的产生。Th1/Th2、Th17/Treg细胞在数量及功能上相互制约,Th1/Th2、Th17/Treg免疫失衡易加剧炎症反应的产生,恢复免疫平衡对CVA的气道抗炎治疗尤为重要。该文对Th1/Th2、Th17/Treg失衡与CVA发病机制进行系统阐述,同时对中药复方、单味中药及其有效成分调控免疫失衡治疗CVA的最新研究进行梳理,为揭示中医药调节免疫平衡治疗CVA的科学内涵及CVA临床治疗和基础研究的开展提供思路和借鉴。
Cough variant asthma (CVA) is a chronic respiratory disease with cough as its main symptom. The occurrence of CVA is closely related to non-specific airway inflammation, and its pathogenesis involves environmental, genetic, immune, and other factors. In recent years, the advantages of traditional Chinese medicine (TCM) in the treatment of CVA have attracted the attention of experts and scholars in China and abroad, especially its prominent role in regulating immune balance, relieving cough symptoms in CVA patients, and reducing recurrence. T Helper cells 1 (Th1), T helper cells 2 (Th2), T helper cells 17 (Th17), and regulatory T cells (Treg) are derived from CD4
+
T cells. Immune imbalance of Th1/Th2 and Th17/Treg is a new hotspot in the pathogenesis of CVA and a potential key target in the treatment of CVA by TCM. Th cell subsets are in dynamic balance under physiological conditions, maintaining respiratory immune homeostasis in which pro-inflammatory cytokines and anti-inflammatory cytokines are balanced. Immature helper T cells (Th0) can be differentiated into Th1, Th2, Th17, Treg, and other cell subsets due to cytokine types in the microenvironment in the stage of CVA maturation. The proliferation of Th2 cells leads to eosinophilic airway inflammation. Excessive differentiation of Th17 cells induces neutrophil airway inflammation. Th1/Th2 and Th17/Treg cells are mutually restricted in number and function, and the immune imbalance of Th1/Th2 and Th17/Treg is easy to aggravate the generation of inflammatory response. Restoring immune balance is particularly important for the airway anti-inflammatory therapy of CVA. In this paper, the imbalance of Th1/Th2 and Th17/Treg and the pathogenesis of CVA were systematically expounded. Meanwhile, the latest research on the regulation of immune imbalance by TCM compound, single TCM, and its effective ingredients in the treatment of CVA was reviewed. It provides ideas and references for revealing the scientific connotation of TCM regulating immune balance therapy of CVA, as well as the development of clinical treatment and basic research of CVA.
中华医学会呼吸病学分会哮喘学组 . 咳嗽的诊断与治疗指南(2021) [J]. 中华结核和呼吸杂志 , 2022 , 45 ( 1 ): 13 - 46 .
MORICE A H , MILLQVIST E , BIEKSIENE K , et al . ERS guidelines on the diagnosis and treatment of chronic cough in adults and children [J]. Eur Respir J , 2020 , 55 ( 1 ): 1901136 .
LUND S , WALFORD H H , DOHERTY T A . Type 2 innate lymphoid cells in allergic disease [J]. Curr Immunol Rev , 2013 , 9 ( 4 ): 214 - 221 .
张利 , 邱忠民 . 咳嗽变异性哮喘的争议问题 [J]. 中国呼吸与危重监护杂志 , 2021 , 20 ( 9 ): 609 - 612 .
MATSUOKA H , NIIMI A , MATSUMOTO H , et al . Inflammatory subtypes in cough-variant asthma: Association with maintenance doses of inhaled corticosteroids [J]. Chest , 2010 , 138 ( 6 ): 1418 - 1425 .
李雯 , 赵伟伟 , 葛建敏 , 等 . 咳嗽变异性哮喘患儿外周血miR-155、SOCS-1表达变化与Th1/Th2失衡的关系 [J]. 山东医药 , 2021 , 61 ( 4 ): 47 - 50 .
RYBKA-FRACZEK A , DABROWSKA M , GRABCZAK E M , et al . Inflammatory phenotypes of cough variant asthma as response predictors to anti-asthmatic therapy [J]. J Inflamm Res , 2022 , 15 : 595 - 602 .
WU Q , HUANG Y , ZHOU Y , et al . Study of the association of interferon- γ gene polymorphisms and Th1/Th2 balance in tuberculosis susceptibility [J]. Am J Transl Res , 2021 , 13 ( 5 ): 5533 - 5539 .
KEECH C , ALBERT G , CHO I , et al . Phase 1-2 trial of a SARS-CoV-2 recombinant spike protein nanoparticle vaccine [J]. N Engl J Med , 2020 , 383 ( 24 ): 2320 - 2332 .
LIU J , YIN W , WESTERBERG L S , et al . Immune dysregulation in IgG(4)-related disease [J]. Front Immunol , 2021 , doi: 10.3389/fimmu.2021.738540 http://dx.doi.org/10.3389/fimmu.2021.738540 .
SHIOYA T , SATAKE M , SANO M , et al . Effect of suplatast tosilate, a Th2 cytokine inhibitor, on cough variant asthma [J]. Eur J Clin Pharmacol , 2002 , 58 ( 3 ): 171 - 176 .
王志刚 , 申改青 , 黄玉焕 . 咳嗽变异性哮喘患儿外周血miR-138及RUNX3对Th1/Th2平衡的调节作用 [J]. 中国当代儿科杂志 , 2021 , 23 ( 10 ): 1044 - 1049 .
FINOTTO S , NEURATH M F , GLICKMAN J N , et al . Development of spontaneous airway changes consistent with human asthma in mice lacking T-bet [J]. Science , 2002 , 295 ( 5553 ): 336 - 338 .
KUPERMAN D A , HUANG X , KOTH L L , et al . Direct effects of interleukin-13 on epithelial cells cause airway hyperreactivity and mucus overproduction in asthma [J]. Nat Med , 2002 , 8 ( 8 ): 885 - 889 .
LIU Y J , TANG B , WANG F C , et al . Parthenolide ameliorates colon inflammation through regulating Treg/Th17 balance in a gut microbiota-dependent manner [J]. Theranostics , 2020 , 10 ( 12 ): 5225 - 5241 .
KRISHNAMOORTHY N , DOUDA D N , BRUGGEMANN T R , et al . Neutrophil cytoplasts induce T(H)17 differentiation and skew inflammation toward neutrophilia in severe asthma [J]. Sci Immunol , 2018 , 3 ( 26 ): eaao4747
王洁 , 王丹丹 , 潘永 , 等 . 嗜酸性粒细胞、白细胞介素-23/Th17轴及小气道功能与小儿咳嗽变异性哮喘的相关性分析 [J]. 安徽医药 , 2021 , 25 ( 3 ): 537 - 540 .
刘坤 , 戴爱国 , 蒋永亮 . 孟鲁司特钠对老年咳嗽变异性哮喘患者炎症因子辅助性T细胞17、调节性T细胞的影响 [J]. 社区医学杂志 , 2014 , 12 ( 23 ): 42 - 44 .
LAAN M , LOTVALL J , CHUNG K F , et al . IL-17-induced cytokine release in human bronchial epithelial cells in vitro : Role of mitogen-activated protein (MAP) kinases [J]. Br J Pharmacol , 2001 , 133 ( 1 ): 200 - 206 .
LACHOWICZ-SCROGGINS M E , DUNICAN E M , CHARBIT A R , et al . Extracellular DNA, neutrophil extracellular traps, and inflammasome activation in severe asthma [J]. Am J Respir Crit Care Med , 2019 , 199 ( 9 ): 1076 - 1085 .
CHAKIR J , SHANNON J , MOLET S , et al . Airway remodeling-associated mediators in moderate to severe asthma: Effect of steroids on TGF-beta, IL-11, IL-17, and type Ⅰ and type Ⅲ collagen expression [J]. J Allergy Clin Immunol , 2003 , 111 ( 6 ): 1293 - 1298 .
王春燕 , 隆红艳 . 黄龙止咳口服液对咳嗽变异性哮喘模型小鼠的作用机制研究 [J]. 天津中医药大学学报 , 2020 , 39 ( 3 ): 330 - 335 .
黄亚若 . 黄龙合剂通过调节IL-4/P-STAT6及CaSR影响小儿咳嗽变异性哮喘气道高反应性机制研究 [D]. 南京 : 南京中医药大学 , 2021 .
张红艳 , 赵淑景 , 田菲 . 槐杞黄颗粒佐治小儿咳嗽变异性哮喘对免疫球蛋白、T淋巴细胞亚群及细胞因子的影响 [J]. 海南医学院学报 , 2017 , 23 ( 3 ): 404 - 407 .
候丹 , 黄帅阳 , 吕明圣 , 等 . 桑梅止咳颗粒对咳嗽变异性哮喘大鼠气道炎症反应的作用及机制 [J]. 中国实验方剂学杂志 , 2022 , 28 ( 2 ): 62 - 66 .
翟慧媛 , 唐鸿 , 于雷 , 等 . 基于IL-6/STAT3、IL-13/STAT6信号通路探讨钩薄过敏颗粒对CVA大鼠气道炎症的影响 [J]. 中药材 , 2022 , 45 ( 1 ): 204 - 208 .
任宇哲 , 万军 , 于宙 , 等 . 基于糖皮质激素受体介导TGF- β 1 /Smad3信号轴探讨小青龙汤加减合二陈汤治疗咳嗽变异性哮喘的药效及机制 [J]. 中医药导报 , 2021 , 27 ( 8 ): 10 - 14 .
黄彦鹏 , 吉训超 , 叶书含 , 等 . 五虎汤对咳嗽变异性哮喘大鼠血清IL-33和TSLP水平的影响及机制研究 [J]. 现代生物医学进展 , 2022 , 22 ( 15 ): 2813 - 2817 .
江智豪 , 胡燕 , 王孟清 , 等 . 五虎汤通过干预炎症记忆对咳嗽变异性哮喘小鼠的治疗作用 [J]. 湖南中医药大学学报 , 2021 , 41 ( 4 ): 512 - 517 .
张宁宁 , 吴力群 , 陈海鹏 , 等 . 加味六安煎对咳嗽变异性哮喘豚鼠血清IL-2、IL-12及IL-13水平影响 [J]. 辽宁中医药大学学报 , 2021 , 23 ( 10 ): 21 - 24 .
孙洮玉 , 杨斌 , 徐荣谦 , 等 . 加味芎蝎散对咳嗽变异性哮喘大鼠咳嗽反应及气道平滑肌中IL8-CXCR1通路蛋白表达的影响 [J]. 中华中医药学刊 , 2020 , 38 ( 2 ): 8 - 10 .
严文有 , 李有成 , 赵斌庆 , 等 . 僵卿金沸草散治疗咳嗽变异性哮喘疗效观察 [J]. 西部中医药 , 2014 , 27 ( 9 ): 97 - 99 .
秦钰 , 郝华 , 洪天一 , 等 . 麻黄定喘汤对咳嗽变异性哮喘模型小鼠Th1/Th2类细胞因子水平的影响 [J]. 延边大学医学学报 , 2011 , 34 ( 4 ): 262 - 264 .
陈婧婧 , 郑健 . 麻杏石甘汤加味治疗小儿咳嗽变异性哮喘疗效观察及对患儿血清IL-13、IFN- γ 的影响 [J]. 福建中医药 , 2019 , 50 ( 3 ): 23 - 24,40 .
胡佳 , 沈波 . 止嗽散对咳嗽变异性哮喘大鼠气道炎性反应及外周血Th1/Th2平衡的影响 [J]. 世界中医药 , 2021 , 16 ( 2 ): 238 - 241,267 .
肖愉箫 , 张亚杰 , 王星 . 三拗汤对咳嗽变异性哮喘小鼠Th17/Treg免疫平衡的影响 [J]. 中成药 , 2023 , 45 ( 4 ): 1300 - 1304 .
杜丽娟 , 何成诗 , 由凤鸣 , 等 . 敏咳煎对咳嗽变异性哮喘大鼠Treg/Th17细胞及相关细胞因子的影响 [J]. 辽宁中医杂志 , 2017 , 44 ( 3 ): 601 - 603, 后插2.
景伟超 , 王有鹏 , 李竹英 , 等 . 抗支糖浆对CVA模型鼠TLR4/MyD88信号通路的影响 [J]. 时珍国医国药 , 2022 , 33 ( 8 ): 1865 - 1868 .
景伟超 . 抗支糖浆对CVA豚鼠模型Th17/Treg失衡的免疫调节机制研究 [D]. 哈尔滨 : 黑龙江中医药大学 , 2018 .
张树娟 , 张海龙 , 张东 , 等 . 基于数据挖掘和网络药理学的咳嗽变异性哮喘用药规律及机制研究 [J]. 中药新药与临床药理 , 2022 , 33 ( 9 ): 1218 - 1227 .
夏清青 , 祁佳 , 张宇锋 , 等 . 网络药理学方法确定黄芪对咳嗽变异性哮喘的药理机制及临床疗效验证 [J]. 贵州医药 , 2022 , 46 ( 7 ): 1011 - 1013,1016 .
徐轩 , 王彬 , 陈三 . 黄芪注射液对咳嗽变异性哮喘的免疫调节作用 [J]. 内科急危重症杂志 , 2014 , 20 ( 5 ): 322 - 324 .
藕二祥 . 柴胡皂苷d治疗咳嗽变异性哮喘的实验研究 [J]. 湖南中医杂志 , 2016 , 32 ( 6 ): 172 - 174 .
孙洮玉 , 任军华 , 杨斌 . 川芎嗪对咳嗽变异性哮喘大鼠气道平滑肌组织转化生长因子通路相关蛋白表达的影响 [J]. 中国临床药理学杂志 , 2021 , 37 ( 23 ): 3266 - 3268 .
韩晓慧 . 阿那其根醇提取物对咳嗽变异性哮喘作用机制体外研究 [D]. 乌鲁木齐 : 新疆医科大学 , 2019 .
杨娟 . 浅析咳嗽变异性哮喘的中医辨证论治 [J]. 世界最新医学信息文摘 , 2017 , 17 ( 92 ): 103 - 110 .
于琳琳 , 王婧 , 邹亚 , 等 . 五虎汤加味对RSV感染哮喘小鼠气道炎症及肺组织Muc5AC、STAT3、NF- κ B、NLRP3蛋白表达的影响 [J]. 中国实验方剂学杂志 , 2023 , 29 ( 19 ): 108 - 115 .
仇志锴 , 王春莲 , 尤士军 , 等 . 麻杏石甘汤合过敏煎加味对咳嗽变异性哮喘患儿症状改善及诱导痰炎性因子的影响 [J]. 中国实验方剂学杂志 , 2023 , 29 ( 8 ): 214 - 219 .
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