严重哮喘伴真菌致敏

R. Prasad, S. M. Ahsan Kazmi, R. Kacker, N. Gupta
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引用次数: 1

摘要

支气管哮喘是一种气道炎症性疾病,可因许多外在因素而恶化。最常见的触发因素是持续暴露于过敏原,其中真菌是重要因素。一种新的哮喘表型称为严重哮喘与真菌致敏(SAFS)已被描述。通过存在严重哮喘、真菌致敏和没有过敏性支气管肺曲霉病来诊断。SAFS更多的是一种排斥诊断。SAFS的初期治疗应与重症哮喘类似,包括人源化抗ige单克隆抗体和其他生物制剂。这些患者通常不能通过常规的严重哮喘治疗,即大剂量吸入皮质类固醇和长效支气管扩张剂来缓解症状。长期使用口服皮质类固醇和脉冲大剂量静脉注射皮质类固醇是有效的。有一些证据表明,包括伊曲康唑在内的抗真菌药物的作用,但其作为一种特定的治疗方法需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Severe asthma with fungal sensitization
Bronchial asthma is an inflammatory disease of the airways, which may be worsened due to many extrinsic factors. The most common trigger is the continuous exposure to allergens, of which fungal agents are important factors. A new phenotype of asthma called severe asthma with fungal sensitization (SAFS) has been described. It is diagnosed by the presence of severe asthma, fungal sensitization, and absence of allergic bronchopulmonary aspergillosis. SAFS is more of a diagnosis of exclusion. Treatment of SAFS initially should be similar to that of severe asthma including humanized anti-IgE monoclonal antibody and other biologics. These patients usually do not have their symptoms relieved with conventional treatment of severe asthma, i.e. high-dose inhaled corticosteroids and long-acting bronchodilators. Prolonged use of oral corticosteroids and pulse high-dose intravenous corticosteroid is effective. There are some evidence implicating the role of antifungal agents including itraconazole, but its use as a specific therapy requires further studies.
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