中文摘要：

气道高反应的发病机制目前仍然不清楚，但人多数人认同是气道的一种慢性炎症。近十年来，上皮缺陷学说逐渐成为解释气道高反应机制的主流观点。气道上皮不再被仅仅看作为单纯的机械屏障，而是机体内环境与外部环境相互作用的界面。气道上皮具有广泛的生理作用，包括抗氧化、内分泌和外分泌、黏液运输、生物代谢、结构性黏附、损伤修复、应激或炎症信号传递、抗原递呈作用等。借助这些生理作用，支气管上皮细胞在气道局部微环境稳态维持中发挥重要作用。有理由相信，气道上皮的结构完整性缺陷或功能紊乱是哮喘和慢性阻塞性肺疾病等气道高反应性疾病的启动环节。

英文摘要：

It is commonly accepted that airway hyperresponsiveness （AHR） is a chronic airway inflammation although the exact mechanism of its pathogenesis is still unclear. In the past ten years, an epithelial defect hypothesis has gradually gained supports from the main stream. Airway epithelium is no longer considered only as a simple mechanic barrier but an active interface between the inner and outer environment. Bronchial epithelial cells play a critical role in maintenance of homeostasis in the airway local microenvironment through a wide range of physiologic functions including anti-oxidation, exocrine/endocrine secretions, mucus production and antigen presentation under health and stressed/inflamed/injured conditions. It is reasonably hypothesized that disruption of these functional processes or defects in airway epithelium integrity may be the initial steps leading to airway hyperresponsiveness such as in asthma and chronic obstructive pulmonary disease.