重症哮喘发生机制研究新进展
Research Progress in the Pathogenesis of Severe Asthma
DOI: 10.12677/acm.2026.1641635, PDF,   
作者: 甘唐翘楚*, 符 州#：重庆医科大学附属儿童医院呼吸科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，重庆市干细胞治疗工程技术研究中心
关键词: 重症哮喘；哮喘表型；气道上皮；感染；遗传因素；Severe Asthma； Asthma Phenotypes； Airway Epithelial； Infection； Genetic Factors
摘要: 支气管哮喘(Asthma)是儿童及成人常见的慢性气道炎症性疾病，我国的哮喘整体诊断率、治疗率、控制率仍不理想，给患者、家庭及社会带来了沉重的疾病负担。糖皮质激素(Glucocorticoids)为哮喘治疗的一线核心药物，但部分患者存在糖皮质激素抵抗，甚至进展为重症哮喘(Severe Asthma)，其发病机制尚未完全阐明。本文围绕哮喘表型的异质性、气道上皮屏障功能损伤、气道上皮炎症调控紊乱、感染及遗传因素五大关键环节，系统综述其在重症哮喘发生及糖皮质激素抵抗中的作用机制。上述多因素相互作用、协同调控，共同构成重症哮喘与糖皮质激素抵抗的核心病理生理网络。未来针对上述关键靶点开展精准干预研究，有望进一步提高哮喘治疗效能、降低重症哮喘发生率，为重症哮喘的个体化防治提供新的理论依据与方向。
Abstract: Bronchial asthma is a common chronic inflammatory airway disease in children and adults. In China, the overall rates of diagnosis, treatment, and well-controlled of asthma remain unsatisfactory, imposing a heavy disease burden on patients, families, and society. Glucocorticoids are the first-line core drugs for asthma therapy; however, some patients exhibit glucocorticoid resistance and even progress to severe asthma, whose pathogenesis has not yet been fully elucidated. This article systematically reviews the mechanisms of five key components, namely the heterogeneity of asthma phenotypes, impaired airway epithelial barrier function, dysregulated inflammatory regulation function of airway epithelium, infection, and genetic factors, in the development of severe asthma and glucocorticoid resistance. These multiple factors interact and regulate synergistically, jointly constituting the core pathophysiological network of severe asthma and glucocorticoid resistance. Future studies targeting the precise intervention of above key nodes are expected to further improve the efficacy of asthma treatment, reduce the incidence of severe asthma, and provide new theoretical basis and directions for individualized prevention and treatment of severe asthma.
文章引用：甘唐翘楚, 符州. 重症哮喘发生机制研究新进展[J]. 临床医学进展, 2026, 16(4): 3705-3715. https://doi.org/10.12677/acm.2026.1641635

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