抗 IgE 治疗在缓解支气管哮喘中的作用

N. Trushenko, B. Lavginova, V. A. Stener, S. N. Avdeev
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引用次数: 0

摘要

支气管哮喘是最常见的呼吸系统疾病之一,10% 的患者临床症状严重。70-80% 的重症哮喘患者有 2 型(T2)炎症的迹象,临床上将其定义为血液和气道中嗜酸性粒细胞数量的增加。基因工程生物药物的出现使人们有可能重新审视哮喘治疗的目的,即实现缓解而不是疾病控制,这包括在不使用全身性糖皮质激素治疗的情况下控制症状、无加重、功能参数稳定和生物标志物正常化。临床研究表明,使用基因工程生物药物治疗可降低哮喘加重的频率,减少对全身性糖皮质激素维持治疗的需求,缓解症状,改善生活质量,从而使19.6%-31.6%的患者病情得到缓解。对生物疗法反应不理想的预测因素包括:体重指数高、入住重症监护室、有严重哮喘加重病史以及最初的临床表现更严重。奥马珠单抗疗法对特应性重症哮喘患者的疗效最为显著,这些患者表现出的症状和病情加重与过敏致敏临床相关,皮肤点刺试验阳性结果和(或)血清过敏原特异性 IgE 鉴定、T2 生物标志物水平升高均证实了这一点。本出版物介绍了有关哮喘缓解的最新数据:概念、基本标准以及基因工程生物药物在实现缓解中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of anti-IgE therapy in achieving remission of bronchial asthma
Bronchial asthma is one of the most common respiratory diseases, and follows a severe clinical course in 10% of patients. 70–80% of patients with severe asthma have signs of type 2 (T2) inflammation, which is clinically defined as an increase in blood and airways eosinophil counts. The emergence of genetically engineered biological drugs has made it possible to review the purpose of asthma therapy, that is, achieving remission instead of disease control, which includes managing the symptoms, absence of exacerbations, stabilization of functional parameters and normalization of biomarkers in the absence of therapy with systemic glucocorticoids. Clinical studies have shown that therapy with genetically engineered biological drugs can reduce the frequency of asthma exacerbations, decrease the need for maintenance therapy with systemic glucocorticoids, relieve symptoms, improve quality of life, which results in achieving a disease remission in 19.6–31.6% of patients. Predictors of suboptimal response to biological therapy were a high body mass index, admission to the intensive care unit and a history of severe asthma exacerbations, as well as initially more severe clinical manifestations of the disease. The most pronounced effect of omalizumab therapy was observed in patients with atopic severe asthma showing symptoms and exacerbations that are clinically associated with allergic sensitization confirmed by positive results of skin prick testing and (or) identification of serological allergen-specific IgE, elevated levels of T2 biomarkers. This publication presents the latest data on asthma remission: the concept, basic criteria, as well as the role of genetically engineered biological drugs in achieving a remission.
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