Kuhn Robert
Department of Pharmacy, Practice and Science, College of Pharmacy, University of Kentucky, Lexington, Kentucky 40536, USA.
Pharmacotherapy. 2007 Oct;27(10):1412-24. doi: 10.1592/phco.27.10.1412.
Patients with moderate-to-severe asthma often have persistent symptoms despite aggressive pharmacotherapy, enthusiastic patient compliance, and proper technique in using delivery devices. Persistent symptoms have detrimental effects on patients' quality of life and result in a tremendous financial burden because of an increased utilization of health care resources. Guidelines from the National Asthma Education and Prevention Program list symptom prevention, near-normal lung function, and participation in activities (e.g., school, work) as goals of successful asthma therapy. The development of pharmacologic and biologic therapies that target different aspects of airway inflammation will help patients with persistent asthma symptoms achieve these goals. Immunoglobulin E (IgE) is increasingly recognized as a key component of asthma pathophysiology and contributes to both the early- and late-phase inflammatory cascade of the airways by inhibiting allergen-induced activation of mast cells. Both epidemiologic and clinical evidence support the use of IgE blockade for asthma treatment. Omalizumab is currently the only IgE-targeted therapy approved by the United States Food and Drug Administration for asthma treatment. The drug improves symptoms, reduces exacerbations, and improves quality of life in certain patient populations.
中重度哮喘患者尽管接受了积极的药物治疗、患者积极配合且正确使用给药装置，但仍常出现持续性症状。持续性症状会对患者的生活质量产生不利影响，并因医疗资源利用增加而导致巨大的经济负担。国家哮喘教育与预防计划的指南将症状预防、接近正常的肺功能以及参与活动（如上学、工作）列为成功哮喘治疗的目标。针对气道炎症不同方面的药物和生物疗法的开发将有助于有持续性哮喘症状的患者实现这些目标。免疫球蛋白E（IgE）越来越被认为是哮喘病理生理学的关键组成部分，并通过抑制变应原诱导的肥大细胞活化，在气道的早期和晚期炎症级联反应中发挥作用。流行病学和临床证据均支持使用IgE阻断剂治疗哮喘。奥马珠单抗是目前美国食品药品监督管理局批准用于哮喘治疗的唯一一种靶向IgE的疗法。该药物可改善某些患者群体的症状、减少病情加重并提高生活质量。
