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Causes and diagnostic challenges for the prevalence of asthma in my country

The Annual Meeting of the Chinese Medical Association Breathing Physician Branch 2019 and the 18th China Respiratory Physician Forum opened on the 27th in Fuzhou. During the meeting, the Medical Mai Tong was fortunate to interview Professor Cai Shaoxi, Director of the Department of Respiratory and Critical Medicine of Southern Medical University. The professor has been committed to the diagnosis and research of asthma. The following is an exclusive interview.

Medicine: Recently, “Liu Ye Dao” published the “Chinese Adult Asthma Popularity, Risk Factors and Disease Management Status” research. What do you think cause the prevalence of high asthma in my country?

Cai Shaoxi: This research led by Academician Wang is of great significance. In addition to some patients who have not been controlled by adult asthma, a considerable part of the patients may be caused by other reasons such as living environment, working environment, infection, and perceptual perceptuality.

Occupational environmental factors, such as toluene diisocyanate (TDI), TDI is organic solvents in paint and other materials, such as decoration materials. In general professional environments, there is a safe concentration, but sometimes in certain environments, such as concentration in the decoration, there is concentration in the decoration. Excessive standards, long -term repetitive and low -dose contact for genes may lead to the development of asthma.

In addition, some microorganisms in the environment, such as fungi living in a warm and humid environment, such as molds and chain bacteria, for patients with asthma and sensibility, microorganisms in these environments can also be used as trigger factor for these patients.

Therefore, the occurrence and development of asthma is the result of the common effect of environmental and genetic easily sensuality.

In addition, why the incidence of asthma in our country is increasing, which is similar to the process of industrialized cities worldwide. It may be that related factors such as environmental changes play an important role in the development of asthma. The “hygiene hypothesis” proposed that the occurrence of perverted reactive diseases such as asthma is related to the changes in early childhood living environment and methods, that is, some other microbial components that are naturally exposed in the environment in the early days, such as internal toxin auxiliary factor, may affect immunity, which may affect immunity System development.

Medicine: The diagnostic rate of asthma in clinical clinicals may be relatively low. What are the main reasons do you think?

Cai Shaoxi: At present, the level of research and diagnosis and treatment of asthma in my country is high, but the diagnosis rate of asthma in clinical clinic may be relatively low or challenging.

First, the patient’s own cause. Traditionally, patients usually think that the symptoms of asthma are asthma, but if the cough mutant asthma is mainly cough, many patients do not consciousness as asthma, and often apply antibiotics by themselves. There is also the chest tightness and mutant asthma discovered by Professor Shen Huahao at the Second Affiliated Hospital of Zhejiang University. Patients can only manifest as chest tightness, no breathing and cough symptoms. These are different manifestations of asthma. Due to the diversity of asthma manifestations, patients themselves have different perceptions or their perception of asthma is not high, which limits the diagnosis of patients with asthma patients or special diseases.

Second, lack of effective assessment tools. Clinical doctors need better clinical tools to discover early inflammation of the airway. For example, inducing phlegm -enrichful granulocytes can be done, but the technical conditions required are high, and some grass -roots hospitals cannot be carried out. The exhalation of nitric oxide detection of asthma permethyl inflammation, most of which reacts only the high TH2 high part. The inflammation of the low TH2 is often not reflected well. For lung function testing, mild asthma patients do not necessarily change FEV1. Of course, patients can also detect the variation rate of peak flow rate, but many times, patients need to buy the peak flow velocity instrument or rent it by themselves, and check and record it at home to analyze it to the hospital. The process is cumbersome.

Therefore, the patient’s own sense of symptoms and the lack of effective assessment tools of grass -roots doctors have limited the diagnosis of asthma.

Yantong: Is your team studying the field of asthma? Can you briefly introduce it?

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Cai Shaoxi: At present, the research of our team mainly focuses on environmental factors including dust mites, TDI, etc. that causes the starting of airway mucosal barrier damage and asthma inflammation, as well as possible mechanisms for the inherent immune changes of asthma in the fastest of the thymus lymphocytes (TSLP) Essence The thymatic lymphocyte formin (TSLP) is a cytokine produced by epithelial cells, which mediated the occurrence of asthma inflammation, and the reunion of the airway. At present, monoclonal antibodies for TSLP are doing clinical research.

The inherent immune system consists of a series of host defense mechanisms, which will generate non -specific responses for environmental triggers. The airway epithelial cells participate in the regulation of inherent immune. The TSLP released by it is one of the key factor. How does external allergens or pathogens media formed the release of the airway epithelial cell TSLP and how to recognize the receptor TLR2, TLR4, etc. How the protein (E-Cardhrin) and β-catenin are regulated with each other, and how to participate in the regulation of asthma and airway inflammation, airway remodeling, anti-TSLP monoclonal anti-airway immune tolerance molecular mechanism, etc. are our current research The main content. We look forward to continuing to cooperate with our peers to start more cooperation and exchanges to find asthma’s accurate treatment targets for asthma.


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