哮喘联盟

   摘要
   重度哮喘作为一个异质性疾病，有不同的临床表现和病理生理过程，已经越来越广泛的被认识。重度哮喘患者在日常生活中遭受显著损害，并对医疗资源造成沉重负担。近期联盟小组的工作改进了重度哮喘的定义，同时也更好的定义了重症患者的特征。不同的方法，其中包括无偏倚群集分析，已被用来识别通过临床特征和免疫过程进行定义的重度哮喘表型（亚组）。对重度哮喘表型的识别，并通过区分哪些患者更可能对某些特定药物起作用，促进了靶向治疗的发展。在这篇文章中，我们将探讨对重度哮喘的认识的演变、回顾目前可用的治疗方案和一些正在发展中的富有前景的药物。此外，我们还研究支气管镜在重度哮喘中的作用和支气管热成形术所提供的证据。

（杨冬 审校）
Clin Pulm Med. 2014 Jan 1;21(1):1-8.
 

Severe Asthma: The Evolution of Patient-directed Management.
 

Keller M1, Kamp D1.
 

Abstract
Severe asthma has been increasingly recognized as a heterogenous disease with varied clinical characteristics and pathophysiological processes. Patients with severe asthma suffer significant impairment in their daily life and impose a substantial burden on health care resources. The recent work of consortia groups has led to an improved definition of severe asthma as well as better characterization of the patients with severe disease. Different approaches, including unbiased cluster analyses, have been utilized to identify severe asthma phenotypes (subgroups) defined by their clinical characteristics and immune processes. Recognition of severe asthma phenotypes has assisted the development of targeted therapies by identifying patients more likely to respond to the specific agent. In this article, we discuss the evolution of our understanding of severe asthma and review the currently available therapies and promising drugs in development. In addition, we examine the role of bronchoscopy in severe asthma and the emerging evidence regarding bronchial thermoplasty.
 

Clin Pulm Med. 2014 Jan 1;21(1):1-8.