Article record

通过早期达标治疗策略恢复上皮驱动性疾病中的上皮健康：改善患者护理以实现临床缓解。

Restoring epithelial health in epithelial-driven disease through an early treat-to-target approach: improving patient care towards clinical remission.

综述 Meta鼻科IF 11.6Q1

文献信息

PMID	42815780
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Del Dorscheid 查看其他 13 位作者 Helena Aegerter；Marco Caminati；Julia Eckl-Dorna；Claire Hopkins；Robert E Hynds；David J Jackson；Gianni Marone；Martijn C Nawijn；Christopher O'Callaghan；Oscar Palomares；Klaus F Rabe；Harald Renz；Christopher E Brightling
作者单位	Centre for Heart Lung Innovation, Department of Medicine, University of British Columbia, Vancouver, BC, Canada. 查看其他 13 条单位信息 Laboratory of Immunoregulation and Mucosal Immunology, VIB-UGent Center for Inflammation Research, Ghent, Belgium; Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.；Asthma Center and Allergy Unit, Verona Integrated University Hospital, Verona, Italy; Department of Medicine, University of Verona, Verona, Italy.；Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.；Department of Otolaryngology-Head and Neck Surgery, Guy's and St Thomas' Hospital, London, UK.；Epithelial Cell Biology in ENT Research (EpiCENTR) Group, Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.；Guy's Severe Asthma Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Immunology and Microbial Sciences, King's College London, London, UK.；Department of Translational Medical Sciences (DISMET) and Center for Basic and Clinical Immunology Research (CISI), School of Medicine, University of Naples Federico II, Naples, Italy.；Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Groningen Research Institute on Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, Netherlands.；Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, University College London, London, UK; NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK.；Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University of Madrid, Madrid, Spain.；LungenClinic Grosshansdorf, Grosshansdorf, Germany; Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany; Department of Medicine, Christian-Albrechts University, Kiel, Germany.；Institute of Laboratory Medicine, Member of the German Center for Lung Research (DZL) and the Lung Center of the Universities of Giessen and Marburg (UGMLC), Philipps-University Marburg, Marburg, Germany; Centre of Excellence for Diagnostics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Tongji University School of Medicine, Shanghai, China.；Institute for Lung Health, National Institute for Health and Care Research, Leicester Biomedical Research Centre, University of Leicester, Leicester, UK. Electronic address: ceb17@le.ac.uk.
期刊	The Journal of allergy and clinical immunology
SCI 分区	Q1
IF	11.6
研究类型	综述 Meta · 临床
所属专科	鼻科

中文摘要

背景： 气道上皮的结构和功能在抵御有害环境刺激和维护呼吸健康中处于核心地位；然而，上皮功能障碍可导致气道疾病。上皮健康代表一种平衡状态，其中气道上皮屏障、免疫活性和黏液纤毛动力学协同作用，以维持组织完整性并预防炎症。一个受邀的上皮科学专家组于2025年3月在伦敦召开会议，讨论目前对气道上皮健康的理解，以及在上下气道炎症性疾病中恢复上皮健康的方法。本综述总结了会议期间提出的关键概念。方法：专家组讨论了目前可用的呼吸道上皮破坏生物标志物的优点和缺点，包括黏液栓、通气缺陷、黏蛋白糖蛋白、纤毛摆动频率、紧密连接蛋白和炎症生物标志物。这些讨论强调需要能够直接评估上皮功能的生物标志物，以提高对上皮驱动性气道疾病的理解。结果：还回顾了恢复上皮健康的方法，重点关注黏蛋白产生的正常化、上皮紧密连接的恢复、上皮微生物组的改善以及干细胞治疗，所有这些都显示出临床前景。与会者强调需要采用联合气道方法来管理呼吸系统疾病，涉及多学科、跨专科护理。结论：最后，探讨了呼吸道上皮损伤和修复随时间的轨迹，重点关注达标治疗方法的作用，以及早期干预以恢复上皮健康并在上皮驱动性炎症性气道疾病患者中实现临床缓解。

英文摘要

The structure and function of the airway epithelium are central in protecting against harmful environmental insults and conserving respiratory health; however, epithelial dysfunction can contribute to airway disease. Epithelial health represents a state of equilibrium where the airway epithelial barrier, immune activity and mucociliary dynamics work in concert to maintain tissue integrity and prevent inflammation. An invited Epithelial Science Expert Group met in London in March 2025 to discuss the current understanding of epithelial health in the airways and ways in which epithelial health may be restored in upper and lower inflammatory airway disease. This review summarises the key concepts raised during the meeting. The group discussed the benefits and drawbacks of currently available biomarkers of respiratory epithelial disruption, including mucus plugs, ventilation defects, mucin glycoproteins, cilia beat frequency, tight junction proteins and inflammatory biomarkers. These discussions highlighted a need for biomarkers with the ability to directly assess epithelial function to improve the understanding of epithelial-driven airway disease. Approaches to restore epithelial health were also reviewed, focusing on normalisation of mucin production, restoration of epithelial tight junctions, improvement of the epithelial microbiome, and stem cell therapy, all of which show clinical promise. Attendees highlighted the need for a united airways approach to respiratory disease management, involving multidisciplinary, cross-speciality care. Finally, the trajectory of respiratory epithelial injury and repair over time was explored, focusing on the role of a treat-to-target approach, and early intervention to restore epithelial health and achieve clinical remission in patients with epithelial-driven inflammatory airway disease.