治疗哮喘和慢性阻塞性肺疾病的靶向细胞因子
2018/09/10
摘要
细胞因子在调节和维持哮喘和慢性阻塞性肺病（COPD）中的慢性气道炎症中起关键作用，这使其成为治疗这些疾病有潜力的靶标。哮喘和一些COPD主要由2型免疫反应驱动，包括气道嗜酸性粒细胞，T辅助2（TH2）细胞，2组先天淋巴细胞（ILC2s）以及IL-4、IL-5、IL-13分泌水平的增加。有关阻断这些白细胞介素分泌的抗体的临床试验表明，受试患者急性加重次数和口服皮质类固醇量减少，肺功能和症状得到改善。最近，阻断上游细胞因子如胸腺基质淋巴细胞生成素（TSLP）的方法，在改善患者预后方面显示出前景。重要的是，这些细胞因子阻断剂的临床试验强调了患者选择对于这些昂贵疗法有效与否的重要性，以及需要更好的生物标志物来预测药物反应性。
Targeting cytokines to treat asthma and chronic obstructive pulmonary disease.
Barnes PJ.
Abstract
Cytokines play a key role in orchestrating and perpetuating the chronic airway inflammation in asthma and chronic obstructive pulmonary disease (COPD), making them attractive targets for treating these disorders. Asthma and some cases of COPD are mainly driven by type 2 immune responses, which comprise increased airway eosinophils, T helper 2 (TH2) cells and group 2 innate lymphoid cells (ILC2s) and the secretion of IL-4, IL-5 and IL-13. Clinical trials of antibodies that block these interleukins have shown reduced acute exacerbations and oral corticosteroid use and improvements in lung function and symptoms in selected patients. More recent approaches that block upstream cytokines, such as thymic stromal lymphopoietin (TSLP), show promise in improving patient outcome. Importantly, the clinical trials in cytokine blockade have highlighted the crucial importance of patient selection for the successful use of these expensive therapies and the need for biomarkers to better predict drug responses.
细胞因子在调节和维持哮喘和慢性阻塞性肺病（COPD）中的慢性气道炎症中起关键作用，这使其成为治疗这些疾病有潜力的靶标。哮喘和一些COPD主要由2型免疫反应驱动，包括气道嗜酸性粒细胞，T辅助2（TH2）细胞，2组先天淋巴细胞（ILC2s）以及IL-4、IL-5、IL-13分泌水平的增加。有关阻断这些白细胞介素分泌的抗体的临床试验表明，受试患者急性加重次数和口服皮质类固醇量减少，肺功能和症状得到改善。最近，阻断上游细胞因子如胸腺基质淋巴细胞生成素（TSLP）的方法，在改善患者预后方面显示出前景。重要的是，这些细胞因子阻断剂的临床试验强调了患者选择对于这些昂贵疗法有效与否的重要性，以及需要更好的生物标志物来预测药物反应性。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Nat Rev Immunol. 2018 Jul;18(7):454-466.)
(Nat Rev Immunol. 2018 Jul;18(7):454-466.)
Targeting cytokines to treat asthma and chronic obstructive pulmonary disease.
Barnes PJ.
Abstract
Cytokines play a key role in orchestrating and perpetuating the chronic airway inflammation in asthma and chronic obstructive pulmonary disease (COPD), making them attractive targets for treating these disorders. Asthma and some cases of COPD are mainly driven by type 2 immune responses, which comprise increased airway eosinophils, T helper 2 (TH2) cells and group 2 innate lymphoid cells (ILC2s) and the secretion of IL-4, IL-5 and IL-13. Clinical trials of antibodies that block these interleukins have shown reduced acute exacerbations and oral corticosteroid use and improvements in lung function and symptoms in selected patients. More recent approaches that block upstream cytokines, such as thymic stromal lymphopoietin (TSLP), show promise in improving patient outcome. Importantly, the clinical trials in cytokine blockade have highlighted the crucial importance of patient selection for the successful use of these expensive therapies and the need for biomarkers to better predict drug responses.
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高音调呼吸音在哮喘患儿中的临床应用
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