Article information
RESUMO
A doença pulmonar obstrutiva crónica é uma das principais causas de mortalidade e morbilidade a nível mundial. O tabaco e as características genéticas de cada indivíduo participam seguramente na sua patogenia. Recentemente o processo inflamatório tem sido considerado um dos principais responsáveis pela progressão continua e irreversível da doença, existindo inúmeras células e mediadores implicados.
Neste trabalho efectua-se uma revisão dos diversos protagonistas do processo inflamatório na DPOC, a sua dinâmica, contributo para o desenrolar da doença e procura-se explicar de forma sucinta os porquês da ineficácia terapêutica dos corticosteróides.
REV PORT PNEUMOL 2001; VII (1):
Palavras-chave:
Doença pulmonar obstrutiva crónica
Inflamação
ABSTRACT
Chronic obstructive pulmonary disease is one of the main causes of morbidity and mortality worldwide. Cigarette smoke and genetics are implicated in its pathogenesis. In the last few years, inflammation as been considered one of the most important causes of progression and irreversibility of the disease, with numerous cells and mediators implicated.
In this paper, the role of different protagonists, their relations and contribute to worsening the disease are reviewed. In a brief way we try to explain why corticosteroids are ineffective in COPD.
REV PORT PNEUMOL 2001; VII (1):
Key-words:
Chronic obstructive pulmonary disease
Inflammation
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BIBLIOGRAFIA
[1.]
S. Buist.
Risk factor classification, Comunicação oral. COPD 2000, (2000),
[2.]
US Surgeon General.
The health consequences of smoking: chronic obstructive pulmonary disease. DHHS public nº 84 -50205, (1984),
[3.]
R.B. Devlin, W.F. McDonnell, R. Mann, S. Becker, D.E. House, D. Schreinemachers, H.S. Koren.
Exposure of humans to ambient levels of ozone for 6.6hours causes cellular and biochemical changes in the lung.
Am J Respir Cell Mol Biol, 4 (1991), pp. 72-81
[4.]
J.C. Hogg.
Childhood Viral Infection and the pathogenesis of asthma and chronic obstructive lung disease.
Am J Respir Crit Care Med, 160 (1999), pp. S26-S28
[5.]
R.M. Senior, S.D. Shapiro.
Chronic obstructive pulmonary disease: epidemiology, pathophysiology and pathogenesis.
Fishman "Pulmonary dìseases and disorder.s ", 3,
[6.]
P.J. Barnes.
Molecular genetics of COPD.
Thorax, 554 (1999), pp. 245-252
[7.]
P.D. Paré, T.R. Bai.
Airway wall remodelling in chronic obstructive pulmonary disease.
Eur Respir Rev, 6 (1996), pp. 259-263
[8.]
A.J. Sandford, T.D. Weir, P.D. Pare.
Genetic risk factors for chronic obstructive pulmonary disease.
Eur Respir J, 10 (1997), pp. 1380-1391
[9.]
J.B.M. Mullen, J.L. Wright, B.R. Wiggs, P.D. Paré, J.C. Hogg.
Reassessment of inflammation of airways in chronic bronchitis.
Br Med J, 291 (1985), pp. 1235-1239
[10.]
P.K. Jeffery.
Pathology of asthma and COPD: a synapsis.
Eur Respir Rev, 7 (1997), pp. 111-118
[11.]
R. Finkelstein, H.-D. Ma, H. Ghezzo, K. Whittaker, R.S. Fraser, M.G. Cosio.
Morphometry of small airways in smokers and its relationship to emphysema type and hyperresponsiveness.
Am J Respir Crit. Care Med, 152 (1995), pp. 267-276
[12.]
M. Saetta.
Airway inflammation in chronic obstructive pulmonary disease.
Am J Respir Crit. Care Med, 160 (1999), pp. S17-S20
[13.]
R. Anderson, A.J. Theron, G.A. Richards, M.S. Myers, A.J.V. Rensburg.
Passive smoking by human sensitises circulating neutrophils.
Am Rev Respir Dis, 144 (1991), pp. 570-574
[14.]
G. Turago, A. Di Stefano, P. Maestrelli, et al.
Effects of smoking cessation on airway inflammation in chronic bronchitis.
Am J Respir Crit. Care Med, 152 (1995), pp. 1262-1267
[15.]
M. Cosio, A. Guerassimov.
Chronic obstructive pulmonary disease Inflammation of small airways and lung parenchyma.
Am J Respir Crit. Care Med, 160 (1999), pp. S21-S25
[16.]
W. Macnee, I. Rahman.
Oxidants and Antioxidants as therapeutic targets in chronic obstructive pulmonary dissese.
Am J Respir Crit. Care Med, 160 (1999), pp. S58-S65
[17.]
R.A. Jorres, H. Magnussen.
Oxidative stress in COPD.
Eur Respir Rev, 7 (1997), pp. 131-135
[18.]
W. Macnee.
Neutrophil traffic and COPD.
Eur Respir Rev, 7 (1997), pp. 124-127
[19.]
J.E. Repine, A. Bast, I. Lnakhorst.
Oxidative stress in chronic obstructive pulmonary disease.
Am J Respir Crit. Care Med, 156 (1997), pp. 341-357
[20.]
R.P.N. Dekhuijzen, K.K.H. Abon, I. Dekker, P.H.J. Aarts, P.M.L. Wielders, L.A. Van Herwaaden, A. Bast.
Increased exhalation of hydrogen peroxide in patients with stable and unstable chronic obstructive pulmonary disease.
Am J Respir Crit. Care Med, 154 (1996), pp. 813-816
[21.]
H. Kanazawa, S. Shoji, T. Yoshikawa, K. Hirata, J. Yoshikawa.
Increase production of endogenous nitric oxide in patients with bronchial asthma and chronic obstructive pulmonary disease.
Clin Exp Allergy, 28 (1998), pp. 1244-1250
[22.]
A.G. Agusti, J.M. Villaverde, B. Togores, M. Bosch.
Serial measurements of exhaled nitric oxide during exacerbations of chronic obstructive pulmonary disease.
Eur Respir J, 14 (1999), pp. 523-528
[23.]
S.R. Rutgers, T.W. Van-Der-Mark, W. Coers, H. Moshage, W. Timens, H.F. Kauffman, G.H. Koeter, D.S. Postma.
Markers of nitric oxide metabolism in sputum and exhaled air are not increased in chronic obstructive pulmonary disease.
Thorax, 54 (1999), pp. 576-580
[24.]
I. Kawikova, P.J. Barnes, T. Takahashi, S. Tadjkarimi, M.H. Yacoub, M.G. Belvisi.
8-epiprostaglandin F2α, a novel noncycloxygenase derived prostaglandin, is a potent constrictor of guinea-pig and human airways.
Am J Respir Crit. Care Med, 153 (1996), pp. 590-596
[25.]
D. Pratico, S. Basili, M. Vieri, C. Cordova, F. Violi, G.A. Fitzgerald.
Chronie obstructive pulmonary disease associated with an increase in urinary levels of isoprostane F2α-III, an index of oxidant stress.
Am J Respir Crit. Care Med, 158 (1997), pp. 1709-1714
[26.]
I. Rahnan, D. Morrison, K. Donaldson, W. Macnee.
Systemic oxidative stress in asthma, COPD and smokers.
Am J Respir Crit. Care Med, 154 (1996), pp. 1055-1060
[27.]
P. Mills.
Airway epithelial cells, cytokines and pollutants.
Am J Respir Crit. Care Med, 160 (1999), pp. S29-S32
[28.]
C. Basbaum, H. Lemjabbar, M. Longphre, D. Li, E. Gensch, N. McNamara.
Control of mucin transcription by diverse injury-induced signalling pathways.
Am J Respir Crit. Care Med, 160 (1999), pp. S44-S48
[29.]
P.J. Barnes.
Novel approaches and targets for treatment of chronic obstructive pulmonarv disease.
Am J Respir Crit. Care Med, 160 (1999), pp. S72-S79
[30.]
L. Reid.
An experimental study of hypersecretion of mucus in the bronchial tree.
Br J Exp Pathol, 44 (1963), pp. 437-445
[31.]
S.J. Coles, L.R. Levine, L. Reid.
Hypersecretion of mucus glycoproteins in rat airways induced by tobacco smoke.
Am J Pathol, 94 (1979), pp. 459-471
[32.]
W. Busse, J. Elias, D. Sheppard, S. Banks-Schlegel.
Airway remodelling and repair.
Am J Respir Crit. Care Med, 160 (1999), pp. 1035-1042
[33.]
P.K. Jeffeery.
Inflammation in Chronic Obstructive Lung Disease.
Am J Respir Crit Care Med, 160 (1999), pp. S3-S4
[34.]
H. Kuo, P.J. Barnes, D.F. Rogers.
Cigarette smoke-induced airway globet cell secretion: dose dependent differential nerve activation.
Am J Physiol, 7 (1992), pp. L161-L167
[35.]
L. Borish, L.J. Rosenwasser.
Update on cytokines.
J Allergy Clin. Immunol, 97 (1996), pp. 719-734
[36.]
M. Baggiolini.
Neutrophil activation and the role of interleukin-8 and related cytokines.
Int Arch Allergy Immunol, 99 (1992), pp. 196-199
[37.]
S.J. Levine.
Bronchial epithelial cellcytokine interactions in airway inflammation.
J Invest Med, 43 (1995), pp. 241-249
[38.]
P. Chanez, A.M. Vignola, J. Bousquet.
Remodelling of the airways in chronic obstructive pulmonary diseases.
Eur Respir Rev, 7 (1997), pp. 142-145
[39.]
J.L. Devalia, R.J. Sapsford, D.R. Cundell, C. Rusznak, A.M. Campbell, R.J. Davies.
Human bronchial epithelial cell dysfunction following in vitro exposure to nitrogen dioxide.
Eur Respir J, 6 (1993), pp. 1308-1316
[40.]
C. Rusznak, J.L. Devalia, R.J. Sapsford, R.J. Davies.
Ozone induced mediator retease from human epithelial bronchial cells in vitro and the influence of nedocromil sodium.
Eur Respir J, 9 (1996), pp. 2298-2305
[41.]
W. Sun, R. Wu, J.A. Last.
Effects of exposure to environmental tobacco smoke on a human tracheobronchial epithelial cell line.
Toxicology, 100 (1995), pp. 163-174
[42.]
P.R. Mills, C. Rusznak, R.J. Sapsford, J.L. Devalia, R.J. Davies.
Cigarette smoke induced IL-8 and TNF α from cultured human bronchial epithelial cells of non–smokers, smokers with normal pulmonary function and patients with COPD.
Thorax, 53 (1998), pp. A58
[43.]
V.M. Keatings, P.J. Barnes.
Comparison of inflammatory cytokines in chronic obstructive pulmonarr disease, asthma and controls.
Eur Respir Rev, 7 (1997), pp. 146-150
[44.]
A. Bhowmik, T.A. Seemungal, R.J. Sapsford, J.A. Wedzicha.
Relation of sputum inflammatory, markers to symptoms and lung function changes in COPD exacerbations.
Thorax, 55 (2000), pp. 114-120
[45.]
G.W. Hunninghake, R.G. Crystal.
Cigarette smoking and lung destruction: accumulation of neutrophils in the lungs of cigarette smokers.
Am Rev Respir Dis, 8 (1983), pp. 833-838
[46.]
R.A. Stockley.
New perspectives on the protease/ antiprotease balance.
Eur Respir Rev, 7 (1997), pp. 128-130
[47.]
J.T. Zakrzewski, N.C. Barnes, J.F. Costello, P.J. Piper.
Lipid mediators in cystic fibrosis and chronic obstructive pulmonary disease.
Am Rev Respir Dis, 136 (1987), pp. 779-782
[48.]
C. Haslett.
Granulocyte Apoptosis and Its Role in the Resolution and Control of Lung Inflammation.
Am J Respir Crit Care Med, 160 (1999), pp. S5-S11
[49.]
A.D. Luster.
Chemokines-chemotactic cytokines that mediate inflammation.
N Engl J Med, 338 (1998), pp. 436-445
[50.]
V.M. Keatings, P.D. Collins, D.M. Scott, P.J. Barnes.
Differences in interleukin factor-8 and tumour necrosis factor-alpha in induced sputum from patients with chronic obstructive pulmonary disease and asthma.
Am J Respir Crit Care Med, 153 (1996), pp. 530-534
[51.]
C.G. Llewellyn Jones, D.A. Lomas, R.A. Stockley.
Potential role of recombinant secretory leucoprotease inhibitor in the prevention of neutrophil mediated matrix degradation.
Thorax, 49 (1994), pp. 567-572
[52.]
J.M. Sallenave, J. Shulnann, J. Crossley, M. Jordana, J. Gauldie.
Regulation of secretory leukocyte proteinase inhibitor (SLPI) and elastase-specific inhibitor (ESl/elafin) in human airway epithelial cells by cytokines and neutrophilic enzymes.
Am J Respir Cell Mol Biol, 11 (1994), pp. 733-741
[53.]
R.A. Stockley.
Cellular mechanisms in the pathogenesis of COPD.
Eur Respir Rev, 6 (1996), pp. 264-269
[54.]
R.A. Stockley.
Neutrophils and protease/antiprotease imbalance.
Am J Respir Crit Care Med, 160 (1999), pp. S49-S52
[55.]
P.J. Barnes.
Novel approaches and targets for treatment of clronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 160 (1999), pp. S72-S79
[56.]
D. Burnett, A. Hamba, S.L. Hill, R.A. Stockley.
Neutxophils from subjects with chronic obstructive lung disease show enhanced chemotaxis and extracellular proteolysis.
Lancet, 11 (1987), pp. 1043-1046
[57.]
D.S. Shapiro.
The Macrophage in COPD.
Am J Respir Crit Care Med, 160 (1999), pp. S29-S32
[58.]
R.D. Hautamaki, D.K. Kobayashi, R.M. Senior, S.D. Shapiro.
Macrophage elastase is required for cigarette smoke-induced emphysema in mice.
Science, 277 (1997), pp. 2002-2004
[59.]
G.A. Finley, R.L. O'Driscoll, K.J. Russell, E.M. D'Arcy, J.B. Masterson, M.X. Fitzgerald, C.M. O'Connor.
Matrix metalloproteinase expression and production by alveolar macrophages in emphysema.
Am J Respir Crit Care Med, 156 (1997), pp. 240-247
[60.]
A. Capelli, A. Di Stefano, I. Gnemmi, P. Balbo, C.G. Cerutti, B. Balbi, M. Lusuardi, C.F. Dormer.
Increased MCP-1 and MIP-1 beta in bronchoalveolar lavage fluid of chronic bronchitics.
Eur Respir J, 14 (1999), pp. 160-165
[61.]
S. Takanashi, Y. Nasegawa, Y. Kanehira, K. Yamamoto, K. Fujimoto, K. Satoh, K. Okamura.
lnterleukin 10 level in sputum is reduced in bronchial asthma, COPD and in smokers.
Eur Respir J, 14 (1999), pp. 309-314
[62.]
D.E. Daherty, G.S. Worthen, C. Haslett, P.M. Henson.
Monocyte accumulation at acutely inflamed sites in the rabbit lung is dependent upon initial neutrophil accumulation.
Lab Invest, 59 (1988), pp. 200-213
[63.]
G. Cox, J. Crossley, Z. Xing.
Macrophage engulfment of apoptofic neutrophils contributes to the resolution of acute pulmonary intlammation in viuo.
Am J Respir Cell Mol Biol, 12 (1995), pp. 232-237
[64.]
V.A. Fadok, D.L. Bratton, A. Konowal, P.W. Freed, J.Y. Westeoott, P.M. Henson.
Macrophages that have ingested apoptotic cells in vitro inhibit proinflammatory cytokine production through autocrine/paracrine mechanisms involving TGF-β, PGE2 and PAF.
J Clin Invest, 90 (1998), pp. 1513-1522
[65.]
F.E. Hargreave, R. Leigh.
Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 160 (1999), pp. S53-S57
[66.]
D.S. Postma, B. Rijcken.
The role of atopy and hyperresponsiveness in the development of COPD.
Eur Respir Rev, 7 (1997), pp. 159-162
[67.]
S.I. Rennard.
COPD: Overview of definitions, epidemiology, and factors influencing its development.
Chest, 113 (1998), pp. S235-S241
[68.]
M. Saetta.
Central inflammation in the development of COPD.
Eur Respir Rev, 7 (1997), pp. 109-110
[69.]
L. Martti, I. Qvarfordt, G.C. Riise, A.A. Bengt, S. Larsson, A. Lindén.
Increased levels of interleukin-16 in the airways of tobacco smokers: relationship with peripheral blood T lymphocytes.
Thorax, 54 (1999), pp. 911-916
[70.]
D.M. Kemeny, Vyasb, M. Vukmaliovic-Stejic, M. Thomas, A. Noble, L.C. Loh, B.J. O'Connor.
CD8+ T cell subsets and chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 160 (1999), pp. S33-S37
[71.]
S.R. Rutgers, D.S. Postma, N.H. Ten Hacken, H.F. Kauffman, T.W. Van Der Mark, G.H. Koeter, W. Timens.
Ongoing airway inflammation in patients with COPD who do not currently smoke.
Thorax, 55 (2000), pp. 12-18
[72.]
J.W. De Jong, B. Van Der Beltgritter, G.H. Koeter, D.S. Postma.
Peripheral blood lymphocytes cell subsets in subjects with chronic obstructive pulmonary disease: association with smoking, IgE and lung function.
Respir Med, 91 (1997), pp. 67-76
[73.]
W. Timens, W. Coers, J.F.M. Van Straaten, D.S. Postna.
Extracellular matrix and inflammation: a role for fibroblast-mediated defective tissue repair in the pathogenesis of emphysema?.
Eur Respir Rev, 7 (1997), pp. 119-123
[74.]
S.I. Rennard.
Inflammation and repair processes in chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 160 (1999), pp. S12-S16
[75.]
D.E. Niewoehner.
Anatomic and pathophysiological correlations in COPD.
Textbook of Pulmonary Diseases, pp. 823-842
[76.]
E. Puchelle, J.-M. Zahm, J.-M. Tournier, S. De Bentzmann.
Airway epithelial injury and repair.
Eur Respir Rev, 7 (1997), pp. 136-141
[77.]
S. Rennard.
Pathaphysiological mechanisms of COPD.
Eur Respir Rev, 7 (1997), pp. 206-210
[78.]
D.E. Cantral, J.H. Sisson, T. Veys, S.I. Rennard, J.R. Spurzem.
Effects of cigarette smoke extract on bovine bronchial epithelial cell attachment and migration.
Am J Physiol, 268 (1995), pp. L723-L728
[79.]
T. Mio, X. Liu, Y. Adachi, I. Striz, C.M. Skold, D.J. Romberger, J.R. Spurzem, M.G. Illig, R.F. Ertl, S.F. Rennard.
Human bronchial epithelial cells modulate collagen gel contraction by fibroblasts.
Am J Physiol, 274 (1998), pp. L119-L126
[80.]
T. Mio, Y. Adachi, S. Carnevali, D.J. Romberger, J.R. Spurzem, S.F. Rennard.
B-adrenergic agonists attenuate fibroblast-mediated contraction of released collagen gels.
Am J Physiol, 270 (1996), pp. L829-L835
[81.]
C.M. Skold, X. Liu, Y.K. Zhu, T. Umino, K. Takigawa, Y. Ohkuni, R.F. Ertl, J.R. Spunem, D.J. Spurzem, D.J. Romberger, R. Brattsand, S.I. Rennard.
Glucocorticoids augment fibroblast mediated contraction of collagen gels by inhibition of endogenous PGE production.
Proc Assoc Am Phyisicians, 111 (1999), pp. 249-258
[82.]
P.M.A. Calverley.
Inhaled corticosteroids are beneficial in chronic obstructive pulmonarr disease.
Am J Respir Crit Care Med, 161 (2000), pp. 341-342
[83.]
P.J. Barnes.
Inhaled corticosteriods are not beneficial in chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 161 (2000), pp. 342-344
[84.]
K. Fujimoto, K. Kubo, H. Yamamoto, S. Yamaguchi, Y. Matsuzawa.
Eosinophilic inflammation in the airway, is related to glucocorticoid reversibility in patients with pulmonary emphysema.
Chest, 115 (1999), pp. 697-702
[85.]
W.H. Thompson, C.P. Nielson, P. Canrallto, N.B. Charan, J.J. Crowley.
Controlled trial of oralprednisone in outpatients with acute COPD exacerbation.
Am J Respir Crit Care Med, 154 (1996), pp. 407-412
[86.]
V.M. Keatings, A. Jatakanon, Y.M. Worsdell, P.J. Barntes.
Effeets of inhaled and oral glucocorticoids on inflammatory induces in asthma and COPD.
Am J Respir Crit Care Med, 155 (1997), pp. 542-548
[87.]
S.V. Culpitt, W. Maziak, S. Loukidis, J.A. Nightingale, J.L. Matthews, P.J. Barnes.
Effect of high dose inhaled steroid on cells, cytokines and proteases in induced sputurn in chronic obstructive pulmonary disease.
Am J Respir Crit Care Med, 160 (1999), pp. 1635-1639
[88.]
I. Rahman, F. Antonicelli, W. Macnee.
Molecular mechanisms of the regulation of glutathione synthesis by tumor necrosis factor-α and dexamethasone in human alveolar epithelial cells.
J Biol Chem, 274 (1999), pp. 5088-5096
[89.]
M.M. Verheggen, P.W. Adriaansensoeting, C.A. Berrevoets, P.T. Van-Hal, A.O. Brinkmann, H.C. Hoogsteden, M.A. Versnel.
Glucocorticoid receptor expression in human bronchial epithelial cells: effects of snoking and COPD.
MediatorsInflamm, 7 (1998), pp. 275-281
[90.]
J.M. Sallenave, J. Shulmann, J. Crossley, M. Jordana, J. Gauldie.
Regulation of secretory leukocyte proteinase inhibitor (SLPI) and elastase-specific inhibitor (ESI/elafin) in human airway epithelial cells by cytokines and neutrophilic enzymes.
Am J Respir Cell Mol Biol, 11 (1994), pp. 733-741
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