Biologics and airway remodeling in asthma: early, late, and potential preventive effects

IF 12.6 1区 医学 Q1 ALLERGY
Allergy Pub Date : 2024-11-09 DOI:10.1111/all.16382
G. Varricchi, R. Poto, M. Lommatzsch, G. Brusselle, F. Braido, J. C. Virchow, G. W. Canonica
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引用次数: 0

Abstract

Although airway remodeling in severe and/or fatal asthma is stil considered irreversible, its individual components as a cause of clinical symptoms and/or lung function changes remain largely unknown. While inhaled glucocorticoids have not consistently been shown to affect airway remodeling, biologics targeting specific pathways of airway inflammation have been shown to improve lung function, mucus plugging, and airway structural changes that can exceed those seen with glucocorticoids. This superiority of biologic treatment, which cannot be solely explained by insufficient doses or limited durations of glucocorticoid therapies, needs to be further explored. For this field of research, we propose a novel classification of the potential effects of biologics on airway remodeling into three temporal effects: early effects (days to weeks, primarily modulating inflammatory processes), late effects (months to years, predominantly affecting structural changes), and potential preventive effects (outcomes of early treatment with biologics). For the identification of potential preventive effects of biologics, we call for studies exploring the impact of early biological treatment on airway remodeling in patients with moderate‐to‐severe asthma, which should be accompanied by a long‐term evaluation of clinical parameters, biomarkers, treatment burden, and socioeconomic implications.
生物制剂与哮喘的气道重塑:早期、晚期和潜在的预防效果
虽然严重和/或致命性哮喘的气道重塑一直被认为是不可逆的,但其作为临床症状和/或肺功能变化原因的各个组成部分在很大程度上仍不为人所知。虽然吸入性糖皮质激素尚未被一致证明能影响气道重塑,但针对气道炎症特定途径的生物制剂已被证明能改善肺功能、粘液堵塞和气道结构变化,其效果可能超过糖皮质激素。生物制剂治疗的这种优越性不能完全用糖皮质激素剂量不足或疗程有限来解释,需要进一步探讨。针对这一研究领域,我们提出了一种新的分类方法,将生物制剂对气道重塑的潜在影响分为三种时间效应:早期效应(数天至数周,主要调节炎症过程)、晚期效应(数月至数年,主要影响结构变化)和潜在预防效应(生物制剂早期治疗的结果)。为了确定生物制剂的潜在预防作用,我们呼吁开展研究,探讨早期生物制剂治疗对中重度哮喘患者气道重塑的影响,同时对临床参数、生物标志物、治疗负担和社会经济影响进行长期评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Allergy
Allergy 医学-过敏
CiteScore
26.10
自引率
9.70%
发文量
393
审稿时长
2 months
期刊介绍: Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.
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