哮喘治疗中β2-AR激动药诱发受体脱敏的发生机制及预防进展
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篇名: 哮喘治疗中β2-AR激动药诱发受体脱敏的发生机制及预防进展
TITLE: Mechanism and prevention progress of receptor desensitization induced by β2-AR agonists in the treatment of asthma
摘要: β2-肾上腺素受体(β2-AR)激动药作为治疗支气管哮喘(以下简称“哮喘”)的一线药物,在临床中广泛应用,然而长期使用可导致β2-AR脱敏,降低其临床疗效,致使部分哮喘患者症状控制欠佳。β2-AR激动药引起β2-AR脱敏的机制主要包括慢速脱敏(与气道黏膜β2-AR密度减小有关)和快速脱敏(与刺激性G蛋白脱偶联机制有关)。环磷酸腺苷(cAMP)-蛋白激酶A和cAMP-cAMP激活的交换蛋白信号通路与β2-AR脱敏过程关系密切。糖皮质激素、过氧化物酶体增殖物激活受体γ激动药、ASM-024、中药单药及成方等与β2-AR激动药联合使用时能改善β2-AR的敏感性,从而更好地控制哮喘症状。
ABSTRACT: β2-adrenergic receptor (β2-AR) agonists are widely used as first-line drugs in the treatment of bronchial asthma (hereinafter referred to as “asthma”), but long-term use can lead to β2-AR desensitization and reduce its clinical efficacy, resulting in poor symptom control of some asthma patients. The mechanism of β2-AR desensitization induced by β2-AR agonists mainly includes slow hyposensitization (related to the decrease of β2-AR density in airway mucosa) and rapid hyposensitization (related to the mechanism of stimulatory G protein decoupling). Cyclic adenosine monophosphate(cAMP)-protein kinase A and cAMP- exchange protein activated by cAMP signaling pathways are closely related to β2-AR desensitization. Glucocorticoids, peroxisome proliferator-activated receptor-gamma agonists, ASM-024, Chinese medicine monotherapies and formulations, when combined with β2-AR agonists, can improve the sensitivity of β2-AR, so as to better control asthma symptoms.
期刊: 2024年第35卷第15期
作者: 段俊亚;张岩;宋桂华;陈小松;郭彦荣;周璇;陈新颖
AUTHORS: DUAN Junya,ZHANG Yan,SONG Guihua,CHEN Xiaosong,GUO Yanrong,ZHOU Xuan,CHEN Xinying
关键字: 支气管哮喘;β2-肾上腺素受体激动药;脱敏;发生机制;预防作用
KEYWORDS: bronchial asthma; β2-adrenergic receptor agonists; desensitization; mechanism of occurrence; prevention effect
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