哮喘和皮肤过敏的新生物治疗方法
2020/02/11
摘要
过敏通常是地方性、复杂性和异质性的疾病，对生活质量影响很大。从发病机制上讲，涉及嗜酸性粒细胞和嗜碱性粒细胞，肥大细胞和体液因子（例如IgE）的2型免疫反应是过敏性疾病的关键驱动因素。对抗过敏疾病有三个策略：预防、对症治疗和病因疗法。作为有效预防和脱敏的先决条件，了解过敏中的分子机制虽然已取得了显著进展，但本文侧重于介绍最有效的对症治疗—针对越来越多的特异性抗体中和特定的免疫途径。我们重点介绍和分类了三种基本慢性过敏性疾病，过敏性哮喘，慢性自发性荨麻疹和特应性湿疹的最新发展。在所有三个示例中，诸如dupilumab或奥马珠单抗的生物制剂已成为可靠而有效的治疗选择。最后，我们展望了这三大社会负担下，将来诊治流程将如何发展。
Eyerich S et al. Allergy. 2019 Aug 23.
Abstract
Allergies are typically endemic, complex and heterogeneous diseases with a high impact at quality of life. Mechanistically, type 2 immune responses involving eosinophil and basophil granulocytes, mast cells and humoral factors such as IgE are key drivers of allergic diseases. Fighting allergic diseases knows three strategies: prevention, symptomatic and causative therapy. While remarkable progress was made in understanding molecular events in allergies as a prerequisite for effective prevention and desensitization, this review article focusses on the most efficient symptomatic treatments - that is using more and more specific antibodies neutralizing particular immune pathways. We highlight and classify recent and upcoming developments in the three prototype chronic allergic diseases allergic asthma, chronic spontaneous urticaria, and atopic eczema. In all three examples, biologics such as dupilumab or omalizumab become reliable and efficient therapeutic options. Finally, we give an outlook how a diagnostic and therapeutic workflow might look like in the near future for these three major burdens of society.
过敏通常是地方性、复杂性和异质性的疾病，对生活质量影响很大。从发病机制上讲，涉及嗜酸性粒细胞和嗜碱性粒细胞，肥大细胞和体液因子（例如IgE）的2型免疫反应是过敏性疾病的关键驱动因素。对抗过敏疾病有三个策略：预防、对症治疗和病因疗法。作为有效预防和脱敏的先决条件，了解过敏中的分子机制虽然已取得了显著进展，但本文侧重于介绍最有效的对症治疗—针对越来越多的特异性抗体中和特定的免疫途径。我们重点介绍和分类了三种基本慢性过敏性疾病，过敏性哮喘，慢性自发性荨麻疹和特应性湿疹的最新发展。在所有三个示例中，诸如dupilumab或奥马珠单抗的生物制剂已成为可靠而有效的治疗选择。最后，我们展望了这三大社会负担下，将来诊治流程将如何发展。
（ 中国医科大学附属第一医院 李文扬 摘译 杨冬 审校）
（Eyerich S et al. Allergy. 2019 Aug 23.）
New biological treatments for asthma and skin allergies.Eyerich S et al. Allergy. 2019 Aug 23.
Abstract
Allergies are typically endemic, complex and heterogeneous diseases with a high impact at quality of life. Mechanistically, type 2 immune responses involving eosinophil and basophil granulocytes, mast cells and humoral factors such as IgE are key drivers of allergic diseases. Fighting allergic diseases knows three strategies: prevention, symptomatic and causative therapy. While remarkable progress was made in understanding molecular events in allergies as a prerequisite for effective prevention and desensitization, this review article focusses on the most efficient symptomatic treatments - that is using more and more specific antibodies neutralizing particular immune pathways. We highlight and classify recent and upcoming developments in the three prototype chronic allergic diseases allergic asthma, chronic spontaneous urticaria, and atopic eczema. In all three examples, biologics such as dupilumab or omalizumab become reliable and efficient therapeutic options. Finally, we give an outlook how a diagnostic and therapeutic workflow might look like in the near future for these three major burdens of society.
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转换为等效吸入装置的成本节约及其对健康结果的影响
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过敏症免疫治疗在哮喘进展中的调节作用----基于人群的队列研究结果
