Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, UK.
Curr Opin Allergy Clin Immunol. 2011 Aug;11(4):381-5. doi: 10.1097/ACI.0b013e328348a8f9.
Asthma is a complex inflammatory disease and current therapy remains inadequate in many sufferers. There is phenotypic heterogeneity in its clinical expression as a consequence of gene-environment interactions and heterogeneity in response to therapy. This review summarizes the current state of knowledge on phenotype-driven treatment of asthma.
Evidence is accumulating that even standard therapies such as inhaled corticosteroids benefit some groups of asthmatic patients more than others. Macrolide antibiotics and antifungal agents are examples of drugs that have established indications outside the field of airways disease but which may benefit a subset of patients with asthma. Finally, new and expensive biological therapies for asthma are emerging that may be highly efficacious, but only for a selected group of patients.
The emergence of novel therapies, in particular highly specific treatments, bring the promise of improving healthcare in asthma but present the challenge of choosing the right therapy for the right patient. Phenotype-driven treatment of asthma is emerging as a potential reality and will pave the way for personalized healthcare.
哮喘是一种复杂的炎症性疾病,目前的治疗方法在许多患者中仍然不够有效。由于基因-环境相互作用和对治疗反应的异质性,其临床表现存在表型异质性。本文综述了目前基于表型的哮喘治疗的研究现状。
越来越多的证据表明,即使是吸入性皮质类固醇等标准疗法,对某些哮喘患者的疗效也优于其他患者。大环内酯类抗生素和抗真菌药物是在气道疾病领域之外具有明确适应证的药物,但可能对哮喘患者的亚组有益。最后,新兴的、昂贵的哮喘生物疗法可能具有很高的疗效,但仅适用于特定的患者群体。
新型疗法的出现,特别是高度特异性的治疗方法,有望改善哮喘患者的医疗保健,但也带来了为合适的患者选择合适治疗方法的挑战。基于表型的哮喘治疗方法正在成为一种潜在的现实,并将为个性化医疗保健铺平道路。