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RESUMO
A inflamação, componente importante da patogenia da asma, tem sido desde há muito referenciada nesta doença, existindo múltiplos trabalhos que demonstram a implicação de várias células e mediadores.
No presente artigo é efectuada uma revisão dos diversos protagonistas do processo inflamatório na asma brônquica, acentuando-se particularmente o papel dos leucotrienos na perpetuação da resposta inflamatória. Foca-se, de forma breve, a possível acção dos anti-leucotrienos e sua importância na modulação da resposta inflamatória das vias aéreas dos doentes com asma.
REV PORT PNEUMOL 1999: V (5): 487-497
ABSTRACT
Inflammation is a very important component of bronchial asthma and, during the last decades, several cells and mediators have been implicated in its pathogenesis.
In this paper, the role of these protagonists on the inflammatory process is reviewed with an emphasis on the role of leukotriens perpetuating inflammation. Leukotrien antagonists and their role on the modulation of airway inflammation are briefly commented.
REV PORT PNEUMOL 1999; V (5): 487-497
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BIBLIOGRAFIA
[1.]
M.S. Dunnill.
The pathology of asthma, with special reference to changes in the bronchial mucosa.
J Clin Pathol, 3 (1960), pp. 27-33
[2.]
B. Burrows, F.M. Hasan, R.M. Barbee, M. Halonen, M.D. Levowjtz.
Epidemiological observations on eosinophilia and its relation to respiratory diseases.
Am Rev Resp Dis, 122 (1980), pp. 709-719
[3.]
E. Pizzichini, M.M.M. Pizzichini, A. Efthimiadis, J. Dolovich, F.E. Hargreave.
Measuring airway inflammation in asthma eosinophils and eosinophilic cationic protein in induced sputum compared with peripheral blood.
J Allergy Clin Immunol, 99 (1997), pp. 539-544
[4.]
J. Kraan, G.H. Koeter, T. Van Der Mark, H.J. Sluiter, K. De Vries.
Changes in bronchial hypereactivity induced by 4 weeks of treatment with anti-asthmatic drugs in patients with allergic asthma: a comparison between budesonide and terbutatine.
J Allergy Clin Immunol, 76 (1985), pp. 628-636
[5.]
K.F. Kerrebijn, E.E. Van Essen-Zandvliet, J. Neijens.
Effect of long-term treatment with inhaled corticosteroids and beta-agonists on the bronchial responsiveness in children with asthma.
J Allergy Clin Immunol, 79 (1987), pp. 653-659
[6.]
T. Haahtela, M. Jarvinen, T. Kava, K. Kiviranta, S. Koskinen, K. Lehtonen, K. Nikander, T. Persson, K. Reinikainen, O. Selroos.
Comparison of a beta2-agonist, terbutaline, with na inhaled corticosteroid, budesonide, in newly detected asthma.
N Engl J Med, 325 (1991), pp. 388-392
[7.]
E.E. Van Essen-Zandvuet, M.D. Hughes, H.J. Waalkens, E.J. Duiverman, S.J. Pocock, K.F. Kerrebijn.
Effects of twenty two months treatment with inhaled corticosteoids and/or beta2-agonists on lung function. airways responsiveness and symptoms in children with asthma.
Am Rev Respir Dis, 146 (1992), pp. 447-554
[8.]
J. Bousquet, P. Chanez, Y. Lacoste, G. Barneon, I. Enander, P. Venge, S. Ahlstedt, J. SimonyLafontaine, P. Godard, F.B. Michel.
Eosinophthc inflammation in asthma.
N Engl J Med, 323 (1990), pp. 1033-1039
[9.]
L.A. Laitinen, A. Laitinen, T. Haahtela.
Airway mucosal inflammation even in patients with newly diagnosed asthma.
Am Rev Respir Dis, 147 (1993), pp. 697-704
[10.]
D.L. Smith, R.D. Deshazo.
Broochoalveolar lavage in asthma An update and perspective.
Am Rev Resp Dis, 148 (1993), pp. 523-532
[11.]
P. Jeffery.
Bronchial biopsies and airway inflammation.
Eur Respir J, 9 (1996), pp. 1583-1587
[12.]
W.J. Metzger, D. Zavala, H.B. Richerson, P. Moseley, P. Iwamota, M. Monick, K. Sjoerdsma, G.W. Hunninghake.
Local allergen challenge and bronchoalveolar lavage of allergic asthmatic lungs. Description of the model and local airway inflammation.
Am Rev Respir Dis, 135 (1987), pp. 433-440
[13.]
P. Diaz, M.C. Gonzalez, F.R. Gallegutllos, P. Ancic, O. Cromwell, D. Shepherd, S.R. Durham, G.J. Gleish, A.B. Kay.
Leukocytes and mediators in bronchoalveolar lavage during allergen induced late-phase reactions.
Am Rev Respir Dis, 139 (1989), pp. 1383-1389
[14.]
M.C. Liu, W.C. Hubbard, D. Proud.
Immediate and late inflammatory responses to ragweed antigen challenge of the peripheral airways of asthmatics cellular, mediator and permeability changes.
Am Rev Respir Dis, 144 (1991), pp. 51-58
[15.]
C.C. Hardy, C. Robinson, A.E. Tattersfield, S.T. Holgate.
The bronchoconstrictor effect of inhaled prostaglandine D2 in normal and asthmatic men.
N Engl J Med, 311 (1984), pp. 209-213
[16.]
M.J. Holtzman.
Arachidonic acid metabolism implications of biological chemistry for lung function and disease.
Am Rev Respir Dis, 143 (1991), pp. 188-203
[17.]
B.U. Wintroub, C.E. Kaempfer, N.M. Schechter, D. Proud.
A human lung mast cell chymiotrypsin-like enzyme identification and panial characterization.
J Clin Invest, 77 (1986), pp. 196-201
[18.]
J. Pene, F. Rousset, F. Briere, I. Chretien, X. Paliard, J. Banchereau, H. Spits, J.E. De Vries.
IgE production by normal human B cells induced by alloreactive T cell clones is mediated by IL-4 and suppressed by IFN-gamma.
J Immunol, 141 (1988), pp. 1218-1224
[19.]
Y. Yamagushi, Y. Hayashi, Y. Sugama, Y. Miura, T. Kasahara, S. Kitmaura, M. Torisu, S. Mita, A.T. Tominaga, K. Akatsu.
Highly purified murine interleukin 5 (IL-5) stimulates eosinophil function and prolongs invitro survival. IL-5 as an eosinophil chemotatic factor.
J Exp Med, 1 (1988), pp. 1737-1742
[20.]
T.J. Williams, A. Das, C. Von Uexkull, S. Nourshargh.
Neutrophils in asthma.
Ann N Y Acad Sci, 629 (1991), pp. 73-81
[21.]
S. Sur, T.B. Crotty, G.M. Kephart, B.A. Hyma, T.V. Colby, C.E. Reed, L.W. Hunt, G.J. Gleish.
Sudden-onset fatal asthma: a distinct entity with few eosinophils and relatively more neutrophils in the airway submucosa.
Am Rev Respir Dis, 148 (1993), pp. 713-719
[22.]
G.J. Gleish.
The eosinophil and bronchial asthma current understanding.
J Allergy Clin Immunol, 85 (1990), pp. 422-428
[23.]
J.S. Berman, P.F. Weller.
Airway eosinophils and lymphocytes in ashtma birds of a feather.
Am Rev Respir Dis, 145 (1992), pp. 1246-1248
[24.]
A. Chetta, A. Foresi, M. Del Donno, G.F. Consigli, G. Bertorelu, A. Pesci, R.A. Barbee, D. Olivieri.
Bronchial responsiveness to distilled water and methacholine and its relationship to inflammation and remodelling of the airways in asthma.
Am J Respir Crit Care Med, 153 (1996), pp. 910-917
[25.]
S. Oddera, M. Silvestri, A. Balbo, B.O. Jovovich, R. Penna, E. Crimi, G.A. Rossi.
Airway eosmophilic inflammation. epithelial damage, and bronchial hyperresponsiveness in patients with mild-moderate, stable asthma.
Allergy, 51 (1996), pp. 100-107
[26.]
M. Azzawi, B. Bradley, Y.P.K. Ieffer, A.J. Frew, A.J. Wardlaw, G. Knowles, B. Assoufi, J.V. Collins, S. Durham, A.B. Kay.
Identification of activated T lymphocytes and eosinophils in bronchial biopsies in stable atopic asthma.
Am Rev Respir Dis, 142 (1990), pp. 1407-1413
[27.]
T.A. Springer.
Traffic signals for lymphocyte recirculation and leucocyte emigration: The multistep paradigm.
Cell, 76 (1994), pp. 301
[28.]
P.G.M. Bloemen, P.A.J. Henrjcks, F.P. Nijkamp.
Cell adhesion molecules and asthma.
Clin Exp Allergy, 27 (1997), pp. 128-141
[29.]
K. Ley, T.F. Tedder.
Leucocyte interactions with vascular endothelium New insights into selectin-mediated attachment and rolling.
J Immunol, 155 (1995), pp. 525-528
[30.]
K. Ley, D.C. Bullard, W. Arbones, R. Bosse, D. Vestweber, T.F. Tedder, A.L. Beaudet.
Sequential contribution of L- and P-selectin to leucocyte rolling in vivo.
J Exp Med, 181 (1995), pp. 669-675
[31.]
T.M. Carlos, J.M. Harlan.
Leucocytes endothelial adhesion molecules.
Blood, 84 (1994), pp. 2068-2101
[32.]
A. Acevedo, M.A. Del Pozo, A.G. Arroyo, P. Sachez-Mateos, R. Gonzalez-Amaro, F. Sanchez-Madrid.
Distribution of ICAM-3 bearing cells in normal human tissues. Expression of a novel counter receptor for LFA-1 in epidermal Langerhans cells.
Am J Pathol, 143 (1993), pp. 774-783
[33.]
Y. Shimizu, W. Newman, Y. Tanaka, S. Shaw.
Lymphocyte interactions with endothelial cells.
Immunol Today, 13 (1992), pp. 106-112
[34.]
G.A. Zimmerma, S.M. Prescott, T.M. Macintyre.
Endothelial cell interactions with granulocytes: tethering and signaling molecules.
Immunol Today, 13 (1992), pp. 93-100
[35.]
W.A. Müeller, A.S. Weigl, X. Deng, D.M. Phillips.
PECAM-1 is required for transendothelial migration of leucocytes.
J Exp Med, 178 (1993), pp. 449-460
[36.]
M.H. Thornhill, S.M. Wellicome, D.L. Mahiouz, J.S.S. Lanchboury, U. Kyan-Aung, D.O. Haskard.
Tumor necrosis factor combines with IL-4 or INF-γ to selectively enhance endothelial cell adhesiveness for T cells.
J Immunol, 146 (1991), pp. 592-598
[37.]
M.H. Thornhill, D.O. Haskard.
IL-4 regulates endothelial cell activation by IL-1, tumor necrosis factor or INF-γ.
J Immunol, 145 (1990), pp. 865-872
[38.]
Investigative measures for airway inflammation.
pp. 1066-1132
[39.]
P.K.JefferyJ.Bousquet. Methods for assessment of airways inflammation, 11 (1998),
[40.]
S. Lim, A. Jatakanon, M. John, T. Gilbey, B.J. O’Connor, K.F. Chung, P.J. Barnes.
Effect of inhaled budesonide on lung function and airway inflammation.
Am J Respir Crit Care Med, 159 (1999), pp. 22-30
[41.]
P.J. Barnes, I.M. Adcock.
Glucocorticoid receptors.
The Lung, Second, pp. 40-50
[42.]
B. Samuelsson.
Leukotrienes: mediators of immediate hypersensitivity reactions and inflammation.
Science, 220 (1983), pp. 568-575
[43.]
J.M. Drazen.
Inhalation challenge with sulfidopetide leukotriens in human subjects.
Chest, 89 (1986), pp. 414-419
[44.]
S.-E. Dahlén.
Leucotrien receptors.
Leucotriens, new concepts and target for therapy, pp. 11-23
[45.]
Z. Marom, J.H. Shelhamer, M.K. Bach, D.R. Morton, M. Kauner.
Slow reacting substances, leukotriene C4 and D4, increase the release of mucus from human airways in vitro.
Am Rev Respir Dis, 126 (1982), pp. 449-451
[46.]
Pinto Mendes.
Leucotrienos e asma.
XXII Jomadas de actualização Pneumológica, pp. 65-82
[47.]
J.M. Drazen.
Effects of leukotriens on airway function.
The Lung Scientific Foundations, second, pp. 1287-1296
[48.]
J.M. Drazen, J. Obrien, D. Sparrow, S.T. Weiss, M.A. Martins, E. Israel, C.H. Fanta.
Recovery of leukotrien-E4 from the urine of patients with airway obstruction.
Am Rev Respir Dis, 146 (1992), pp. 104-108
[49.]
K. Asano, C.M. Lilly, W.J. O’Donnell, E. Israel, A. Fisher, B.J. Ransil, J.M. Drazen.
Diurnal variation of urinary leukotrien E4 and histamine excretion rate in normal and mild-to-moderate asthmatic subjects.
J Allergy Clin Immunol, 96 (1995), pp. 646-651
[50.]
G.W. Taylor, I. Taylor, P. Black, N.H. Maltby, N. Turner, R.W. Fuller, C.T. Dollery.
Urinary leucotrien E-4 after antigen challenge and in acute asthma and allergic rhinitis.
Lancet, 1 (1989), pp. 584-588
[51.]
K. Sladek, R. Dworski, G.A. Fitzgerald, K.L. Buitkus, F.J. Block, S.R. Marney Jr., J.R. Sheller.
Allergen-stimulated release of thromboxane A2 and leukotrien E4 in humans Effect of indomethacin.
Am Rev Respir Dis, 141 (1990), pp. 1441-1445
[52.]
P.J. Manning, J. Rokach, J.-L. Malo, D. Ethjer, A. Cartier, Y. Girard, S. Charleson, P.M. O’ Byrne.
Urinary leukotrien E4 levels during early and late asthmatic responses.
J Allergy Clin Immunol, 86 (1990), pp. 211-220
[53.]
J.Y. Westcott, K. Johnston, R.A. Batt, S.E. Wenzel, N.F. Voelkel.
Measurement of petidoleukotriens in biological fluids.
J Appl Physiol, 68 (1990), pp. 2640-2648
[54.]
H.R. Knapp, K. Sladek, G.A. Fitzgerald.
Increased excretion of leukotrien E4 during aspirin-induced asthma.
J Lab Clin Med, 119 (1992), pp. 48-51
[55.]
L.K. Taylor, R. Wellings, G.W. Taylor, R.W. Fuller.
Urinary leukotrien-E4 excretion in exercise-induced asthma.
J Appl Physiol, 73 (1992), pp. 743-748
[56.]
K.P. Hui, I.K. Taylor, G.W. Taylor, P. Rubin, J. Kesteron, N.C. Barnes, P.J. Barnes.
Effect of 5-lypoxyge-nase inhibitor on leukotrien generation and airway responses after allergen challenge in asthmatic patients.
Thorax, 46 (1991), pp. 184-189
[57.]
C.N. Smith, P.E. Cristie, R.J. Hawksworth, F. Thien, T.H. Lee.
Urinary leukotriens-E4 levels after allergen and exercise challenge in bronchtal asthma.
Am Rev Respir Dis, 144 (1991), pp. 1411-1413
[58.]
P.E. Christie, P. Tagari, A.W. Ford-Hutchinson, S. Charlesson, P. Chee, J.P. Arm.
Leeth Urinary leukotrien-E4 concentrations increase after aspirin challenge in aspirin-sensitive asthmatic subjects.
Am Rev Respir Dis, 143 (1991), pp. 1025-1029
[59.]
M. Kumlin, B. Dahlen, T. Bjorck, O. Zetterstrom, E. Granstrom, S.E. Dahlen.
Urinary excretion of leukotrien-E4 and 11-dehydro-thromboxan-B2 in response to bronchial provocations with allergen, aspirin, leukotrien-D4, and histamine in asthmatics.
Am Rev Respir Dis, 146 (1992), pp. 96-103
[60.]
E. Israel, A.R. Fisher, M.A. Rosenberg, et al.
The pivotal role of 5-lypoxygenase products in the reaction of aspirine-sensitive asthmatics to asptrin.
Am Rev Respir Dis, 148 (1993), pp. 1447-1451
[61.]
J.C. Virchow Jr..
Clinical efficacy of the leukotnene receptor antagonists in mild, moderate and severe asthma.
Eur Respir Rev, 8 (1998), pp. 1042-1045
[62.]
J.Á. Leff, W.W. Busse, O.S. Pearlman, E.A. Bronsky, J. Kemp, L. Hendels, R. Dockhorn, S. Kundu, J. Zhang, B.C. Seidenberg, T.F. Reiss.
Montelukast, a leukotriene-receptor antagonist for the treatment of mild asthma and exercise induced bronchoconstriction.
New Engl J Med, 339 (1998), pp. 147-152
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