哮喘联盟

   摘要
   支气管哮喘是最常见的呼吸系统疾病之一。虽然它属于炎症性疾病，但目前对该疾病的诊断及对患者随访的相关指南均基于临床数据和肺功能参数。目前的研究多聚焦于寻找可准确地预测未来疾病风险的相关标记物以及评估这些标记物对于指导药物治疗和改善预后的能力。使用无创方法研究气道炎症受到越来越多的支持。研究诱导痰中的嗜酸性粒细胞可帮助诊断哮喘，但其临床应用是复杂的。一些研究结果显示，检测呼出气体中的一氧化氮浓度（FeNO）可帮助确定疾病表型和改善疾病控制情况。另外，还有研究表明测定呼出气体浓缩物（(EBC）的PH值、某些氧化应激压力相关指标、细胞因子和前列环素与测定呼出气体的温度以及分析挥发性有机化合物（VOCs）对疾病诊断都可能有一定帮助。总之，因为哮喘是一种炎症性疾病，通过无创手段研究气道炎症并控制疾病是可行的。在此方面，虽然诱导痰细胞分析技术在临床中实施似乎很难，但还是非常有意义的。其它研究手段，如测量温度、分析呼出气体中的一氧化氮浓度、呼出气体中的挥发性有机化合物以及呼出气体浓缩物中相关生物标记物等需要更深入的研究以确定其临床适用性。
 

（杨冬 审校）
Int Arch Allergy Immunol. 2015 Feb 27;166(1):1-12. [Epub ahead of print]
 

Usefulness of Noninvasive Methods for the Study of Bronchial Inflammation in the Control of Patients with Asthma.
 

Muñoz X1, Bustamante V, Lopez-Campos JL, Cruz MJ, Barreiro E.

Author information
 

ABSTRACT
Bronchial asthma is one of the most prevalent respiratory conditions. Although it is defined as an inflammatory disease, the current guidelines for both diagnosis and follow-up of patients are based only on clinical and lung function parameters. Current research is focused on finding markers that can accurately predict future risk, and on assessing the ability of these markers to guide medical treatment and thus improve prognosis. The use of noninvasive methods to study airway inflammation is gaining increasing support. The study of eosinophils in induced sputum has proved useful for the diagnosis ofasthma; however, its clinical implementation is complex. Some studies have shown that the measurement of exhaled nitric oxide (FeNO) may also be useful to establish disease phenotypes and improve control. Others have found that the measurement of pH and certain markers of oxidative stress, cytokines and prostanoids in exhaled breath condensate (EBC) may also be useful as well as the measurement of the temperature of exhaled breath and the analysis of volatile organic compounds (VOCs). In conclusion, since asthma is an inflammatory disease, it seems appropriate to try to control it through the study of airway inflammation using noninvasive methods. In this regard, the analysis of induced sputum cells has proved very useful, although the clinical implementation of this technique seems difficult. Other techniques such as temperature measurement, the analysis of FeNO, the analysis of the VOCs in exhaled breath, or the study of certain biomarkers in EBC require further study in order to determine their clinical applicability.
 

Int Arch Allergy Immunol. 2015 Feb 27;166(1):1-12. [Epub ahead of print]