Long Aidan A
Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts, 02114, USA.
Allergy Asthma Proc. 2009 Mar-Apr;30(2):109-19. doi: 10.2500/aap.2009.30.3203.
Asthma represents a syndrome of airway inflammatory diseases with a complex pathology. The immunologic pathogenesis is being increasingly revealed and provides opportunity for targeted biological intervention. This study was designed to describe current experience with immunomodulators as targeted therapy in asthma. A literature review was performed. Targeted therapies have included strategies to activate dendritic cells through the Toll-like receptor (TLR) 9 receptors, to interrupt the action of T(H)2 cytokines with cytokine blockers and monoclonal antibodies, to promote development of T(H)1 responses, to interrupt mast cell signaling, to block IgE mediated pathways, and to block TNF-alpha. Omalizumab is the only biological therapy that has an approved indication in asthma at this time. Improved understanding of the heterogeneity of asthma should allow for specific targeting of different disease phenotype-specific therapies including immunomodulators.
哮喘是一种具有复杂病理的气道炎症性疾病综合征。其免疫发病机制正日益被揭示，为靶向生物干预提供了机会。本研究旨在描述免疫调节剂作为哮喘靶向治疗的当前经验。进行了文献综述。靶向治疗策略包括通过Toll样受体（TLR）9受体激活树突状细胞、用细胞因子阻滞剂和单克隆抗体阻断T辅助（Th）2细胞因子的作用、促进Th1反应的发展、中断肥大细胞信号传导、阻断IgE介导的途径以及阻断肿瘤坏死因子-α（TNF-α）。奥马珠单抗是目前唯一一种在哮喘治疗中有获批适应证的生物疗法。对哮喘异质性的深入理解应有助于针对不同疾病表型的特异性疗法（包括免疫调节剂）进行精准靶向治疗。
