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生物学与疗法的交叉点:成人哮喘的2型靶向疗法

2020/02/11

   摘要
   哮喘是一种可逆性气流阻塞的疾病,临床上以喘息,气短和咳嗽为特征。气道2型细胞因子活性的增加,包括白介素4(IL-4),IL-5和IL-13,现已被认为是哮喘的生物学机制。吸入糖皮质激素已成为哮喘治疗的基础,很大程度上是因为它们减少了2型气道炎症。然而,吸入性或全身性糖皮质激素在许多哮喘患者中无效,而对于激素抵抗性哮喘患者则几乎没有其他治疗选择。尽管皮质类固醇难治性哮喘的机制可能有很多种,但针对2型气道炎症的新型生物制剂的开发为治疗某些皮质类固醇难治性哮喘患者提供了新的方法。本治疗论文的目的是总结新型2型治疗剂,重点是这类新型哮喘治疗剂的生物学原理和临床疗效。

 
(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)
(Lancet. 2020 Feb 1;395(10221):371-383. doi: 10.1016/S0140-6736(19)33005-3.)


 
Intersection of biology and therapeutics: type 2 targeted therapeutics for adult asthma.
 
Peters MC, Wenzel SE.
Lancet. 2020 Feb 1;395(10221):371-383. doi: 10.1016/S0140-6736(19)33005-3.
 
Abstract
Asthma is a disease of reversible airflow obstruction characterised clinically by wheezing, shortness of breath, and coughing. Increases in airway type 2 cytokine activity, including interleukin-4 (IL-4), IL-5, and IL-13, are now established biological mechanisms in asthma. Inhaled corticosteroids have been the foundation for asthma treatment, in a large part because they decrease airway type 2 inflammation. However, inhaled or systemic corticosteroids are ineffective treatments in many patients with asthma and few treatment options exist for patients with steroid resistant asthma. Although mechanisms for corticosteroid refractory asthma are likely to be numerous, the development of a new class of biologic agents that target airway type 2 inflammation has provided a new model for treating some patients with corticosteroid refractory asthma. The objective of this Therapeutic paper is to summarise the new type 2 therapeutics, with an emphasis on the biological rationale and clinical efficacy of this new class of asthma therapeutics.


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