咳嗽型哮喘发病机制及治疗进展
Progress in Pathogenesis and Treatment of Cough Asthma
DOI: 10.12677/ACM.2023.133412, PDF,  被引量   
作者: 程恒杰, 王 欣：新疆医科大学第四临床医学院，新疆 乌鲁木齐；罗建江*：新疆医科大学第四附属医院，新疆 乌鲁木齐
关键词: 咳嗽型哮喘(CVA)；典型哮喘(CA)；气道炎症；气道高反应性；咳嗽；综述；Cough Asthma (CVA)； Typical Asthma (CA)； Airway Inflammation； Airway Hyperresponsiveness； Cough； Review
摘要: 咳嗽型哮喘(cough variant asthma, CVA)是一种不典型的哮喘，以慢性咳嗽，常伴有明显的夜间刺激性咳嗽为主要特征。其不典型的临床表现，极易造成误诊错失最佳治疗时间，最终导致病情转变为典型哮喘。本篇综述将对近年来咳嗽型哮喘最新的发病机制、诊断及治疗情况进行简要总结和归纳。
Abstract: Cough variant asthma (CVA) is a kind of atypical asthma, which is characterized by chronic cough, often accompanied by obvious irritating cough at night. Due to its atypical clinical manifestations, it is easy to cause misdiagnosis and miss the best treatment time, which eventually leads to the transformation of the condition into typical asthma. This review will briefly summarize and sum-marize the latest pathogenesis, diagnosis and treatment of cough asthma in recent years.
文章引用：程恒杰, 王欣, 罗建江. 咳嗽型哮喘发病机制及治疗进展[J]. 临床医学进展, 2023, 13(3): 2911-2917. https://doi.org/10.12677/ACM.2023.133412

参考文献

[1] 中华医学会呼吸病学分会哮喘学组. 支气管哮喘防治指南(2020年版) [J]. 中华结核和呼吸杂志, 2020, 43(12): 1023-1048.
[2] 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.
[3] 赖克方, 陈如冲, 林玲, 等. 不同病因慢性咳嗽临床特征的诊断价值[J]. 中华结核和呼吸杂志, 2009, 32(6): 418-421.
[4] Lai, K. and Long, L. (2020) Current Status and Future Directions of Chronic Cough in China. Lung, 198, 23-29. [Google Scholar] [CrossRef] [PubMed]
[5] 梁瀚文, 易芳, 陈玥晗, 等. 中国慢性咳嗽流行病学调查的现状与展望[J]. 中华结核和呼吸杂志, 2022, 45(1): 100-106.
[6] Stanescu, D.C. and Teculescu, D.B. (1970) Exer-cise- and Cough-Induced Asthma. Respiration, 27, 377-383. [Google Scholar] [CrossRef] [PubMed]
[7] Glauser, F.L. (1972) Variant Asthma. Annals of Allergy, 30, 457-459.
[8] O’connell, E.J., Rojas, A.R. and Sachs, M.I. (1991) Cough-Type Asthma: A Review. Annals of Allergy, 66, 278-282, 285.
[9] Steurer-Stey, C. (2007) Asthma Management: Overview and New Aspects. Praxis (Bern 1994), 96, 1951-1957. [Google Scholar] [CrossRef] [PubMed]
[10] 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(2009版) [J]. 中华结核和呼吸杂志, 2009, 32(6): 407-413.
[11] Carr, T.F., Zeki, A.A. and Kraft, M. (2018) Eo-sinophilic and Noneosinophilic Asthma. American Journal of Respiratory and Critical Care Medicine, 197, 22-37. [Google Scholar] [CrossRef] 
[12] Lai, K., Zhan, W., Wu, F., et al. (2021) Clinical and Inflamma-tory Characteristics of the Chinese APAC Cough Variant Asthma Cohort. Frontiers in Medicine (Lausanne), 8, Article ID: 807385. [Google Scholar] [CrossRef] [PubMed]
[13] 林慧敏, 符昱, 方章福, 等. 嗜酸性粒细胞哮喘的研究进展[J]. 结核与肺部疾病杂志, 2022, 3(4): 328-333.
[14] 陈秀锦, 李丽华. 孟鲁司特钠治疗咳嗽变异性哮喘患儿的近远期临床效果及对血清炎性因子的影响[J]. 河北医学, 2017, 23(2): 208-211.
[15] Halwani, R., Al-Muhsen, S. and Hamid, Q. (2013) T Helper 17 Cells in Airway Diseases: From Laboratory Bench to Bedside. Chest, 143, 494-501. [Google Scholar] [CrossRef] [PubMed]
[16] Xi, X., Liu, J.M. and Guo, J.Y. (2018) Correlation of PD-1/PD-L1 Signaling Pathway with Treg/Th17 Imbalance from Asthmatic Children. International Archives of Allergy and Immunology, 176, 255-267. [Google Scholar] [CrossRef] [PubMed]
[17] 郭靖, 刘亚楠, 郝明明, 等. 哮喘患儿合并肺炎支原体感染免疫状态及Th1/Th2平衡的变化[J]. 中华医院感染学杂志, 2020, 30(9): 1412-1416.
[18] Hassoun, D., Rose, L., Blanc, F.X., et al. (2022) Bronchial Smooth Muscle Cell in Asthma: Where Does It Fit? BMJ Open Respiratory Research, 9, e001351. [Google Scholar] [CrossRef] [PubMed]
[19] Schaafsma, D., Bos, I.S., Zuidhof, A.B., et al. (2008) The In-haled Rho Kinase Inhibitor Y-27632 Protects against Allergen-Induced Acute Bronchoconstriction, Airway Hyperre-sponsiveness, and Inflammation. The American Journal of Physiology-Lung Cellular and Molecular Physiology, 295, L214-L219. [Google Scholar] [CrossRef] [PubMed]
[20] Chiba, Y., Tanoue, G., Suto, R., et al. (2017) Inter-leukin-17A Directly Acts on Bronchial Smooth Muscle Cells and Augments the Contractility. Pharmacological Reports, 69, 377-385. [Google Scholar] [CrossRef] [PubMed]
[21] Rybka-Fraczek, A., Dabrowska, M., Grabczak, E.M., et al. (2021) Does Bronchial Hyperresponsiveness Predict a Diagnosis of Cough Variant Asthma in Adults with Chronic Cough: A Cohort Study. Respiratory Research, 22, 252. [Google Scholar] [CrossRef] [PubMed]
[22] Gao, J., Wu, H.G. and Wu, F. (2020) Small Airways Dysfunc-tion and Bronchial Hyper-Responsiveness in Cough Variant Asthma. International Journal of General Medicine, 13, 1427-1434. [Google Scholar] [CrossRef] 
[23] Lambrecht, B.N. and Hammad, H. (2012) The Airway Epithelium in Asthma. Nature Medicine, 18, 684-692. [Google Scholar] [CrossRef] [PubMed]
[24] Bossley, C.J., Fleming, L., Gupta, A., et al. (2012) Pediatric Severe Asthma Is Characterized by Eosinophilia and Remodeling without T(H)2 Cytokines. Journal of Allergy and Clinical Immunology, 129, 974-982.e13. [Google Scholar] [CrossRef] [PubMed]
[25] Grainge, C.L., Lau, L.C., Ward, J.A., et al. (2011) Effect of Bron-choconstriction on Airway Remodeling in Asthma. The New England Journal of Medicine, 364, 2006-2015. [Google Scholar] [CrossRef] 
[26] Niimi, A., Torrego, A., Nicholson, A.G., et al. (2005) Nature of Airway Inflammation and Remodeling in Chronic Cough. Journal of Allergy and Clinical Immunology, 116, 565-570. [Google Scholar] [CrossRef] [PubMed]
[27] Matsumoto, H., Niimi, A., Tabuena, R.P., et al. (2007) Airway Wall Thickening in Patients with Cough Variant Asthma and Nonasthmatic Chronic Cough. Chest, 131, 1042-1049. [Google Scholar] [CrossRef] [PubMed]
[28] Fahy, J.V. (2015) Type 2 inflammation in Asthma—Present in Most, Absent in Many. Nature Reviews Immunology, 15, 57-65. [Google Scholar] [CrossRef] [PubMed]
[29] Global Initiative for Asthma (2022) Global Strategy for Asthma Management and Prevention.
https://www.ginasthma.org
[30] Auger, L., Mailhot-larouche, S., Tremblay, F., et al. (2016) The Contractile Labil-ity of Smooth Muscle in Asthmatic Airway Hyperresponsiveness. Expert Review of Respiratory Medicine, 10, 19-27. [Google Scholar] [CrossRef] [PubMed]
[31] Nakamura, Y., Tamaoki, J., Nagase, H., et al. (2020) Japa-nese Guidelines for Adult Asthma 2020. Allergology International, 69, 519-548. [Google Scholar] [CrossRef] [PubMed]
[32] Louis, R., Satia, I., Ojanguren, I., et al. (2022) European Respiratory Society Guidelines for the Diagnosis of Asthma in Adults. European Respiratory Journal, 60, Article ID: 2101585. [Google Scholar] [CrossRef] [PubMed]
[33] Côté, A., Russell, R.J., Boulet, L.P., et al. (2020) Managing Chronic Cough Due to Asthma and NAEB in Adults and Adolescents: CHEST Guideline and Expert Panel Report. Chest, 158, 68-96. [Google Scholar] [CrossRef] [PubMed]
[34] Yi, F., Zhan, C., Liu, B., et al. (2022) Effects of Treatment with Montelukast Alone, Budesonide/Formoterol Alone and a Combination of both in Cough Variant Asthma. Respiratory Research, 23, 279. [Google Scholar] [CrossRef] [PubMed]
[35] Tamaoki, J., Yokohori, N., Tagaya, E., et al. (2010) Comparable Effect of a Leukotriene Receptor Antagonist and Long-Acting Beta2-Adrenergic Agonist in Cough Variant Asthma. Al-lergy & Asthma Proceedings, 31, 78-84. [Google Scholar] [CrossRef] [PubMed]
[36] Yousaf, N., Monteiro, W., Parker, D., et al. (2010) Long-Term Low-Dose Erythromycin in Patients with Unexplained Chronic Cough: A Double-Blind Placebo Controlled Trial. Thor-ax, 65, 1107-1110. [Google Scholar] [CrossRef] [PubMed]
[37] Gibson, P.G., Yang, I.A., Upham, J.W., et al. (2017) Effect of Azithromycin on Asthma Exacerbations and Quality of Life in Adults with Persistent Uncontrolled Asthma (AMAZES): A Randomised, Double-Blind, Placebo-Controlled Trial. The Lancet, 390, 659-668. [Google Scholar] [CrossRef] 
[38] Faruqi, S., Sykes, D.L., Crooks, M.G., et al. (2020) Objec-tive Assessment of Cough: An Early Marker of Response to Biological Therapies in Asthma? Lung, 198, 767-770. [Google Scholar] [CrossRef] [PubMed]
[39] 张燕萍, 苗青, 晁燕, 等. 苏黄止咳胶囊治疗咳嗽变异性哮喘的随机对照多中心临床研究[J]. 中医杂志, 2008, 49(6): 504-506.
[40] 邱容, 肖昌武, 富强. 布地奈德福莫特罗联合苏黄止咳胶囊对咳嗽变异性哮喘的疗效观察[J]. 临床肺科杂志, 2017, 22(2): 304-306.
[41] 于小佳. 桑梅止咳颗粒治疗咳嗽变异性哮喘(风伏阴伤证)的临床疗效观察[D]: [硕士学位论文]. 北京: 北京中医药大学, 2018.
[42] 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.

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