摘要
氧化剂增加和抗氧化防御机制之间的不平衡是阻塞性肺部疾病(如哮喘和COPD)的发病机理的中心。在这些患者中,活性氧水平升高。超氧阴离子(O2-),过氧化氢(H2O2)和羟基自由基(•OH)对于在支气管和肺实质中进一步形成细胞毒性自由基至关重要。慢性炎症(部分由氧化应激引起)可通过活化的吞噬细胞(嗜中性粒细胞,嗜酸性粒细胞,巨噬细胞)进一步增加氧化剂负担,尤其是在严重的疾病状态下。实际上,在患病的患者中抗氧化剂和抗炎基因经常被下调。 Nrf2激活抗氧化剂反应元件(ARE),导致GPx上调,硫醇代谢相关的解毒酶(GSTs)和应激反应基因(HO-1)在动物模型以及哮喘和COPD患者中均被下调。存在氧化应激时一氧化氮(NO)的过度产生会促进氧化性反应性氮物种(如过氧亚硝酸盐(ONO2--))的形成,导致硝化作用和DNA损伤,线粒体呼吸抑制,蛋白质功能障碍和细胞生物系统的损害。髓过氧化物酶和H2O2的活化也会引起蛋白质硝化,从而促进亚硝酸盐(NO2-)的氧化。在COPD患者的支气管中,硝基酪氨酸和髓过氧化物酶增加,特别是在严重疾病中。在COPD患者的诱导痰中发现的过氧亚硝酸盐抑制活性降低与肺功能相关。在严重哮喘患者的支气管肺泡灌洗中,蛋白质硝化的标记物-3-硝基酪氨酸,3-溴酪氨酸和3-氯酪氨酸增加。通过使用反硝化机制或抗氧化剂给药的新药物递送策略来针对氧化,亚硝化应激和相关的肺部炎症,可以改善对这些慢性致残性阻塞性肺疾病的治疗。
关键词: 氧化应激,哮喘,COPD,炎症,亚硝化应激,发病机制。
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