Centre Hospitalier Universitaire Montpellier, Montpellier Cedex 05, France.
Int Arch Allergy Immunol. 2012;158(3):216-31. doi: 10.1159/000332924.
Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.
疾病严重程度、活动度、控制和治疗反应性等概念彼此关联但又有所不同。严重程度是指疾病过程引起的器官功能丧失或严重急性加重的发生。严重程度可能随时间而变化，需要定期随访。控制是指目前治疗目标的实现程度。这些概念在哮喘指南、工作组或共识会议中随着时间的推移而不断发展。本文的目的是将 WHO 为慢性过敏性疾病及其相关疾病（鼻炎、慢性鼻-鼻窦炎、慢性荨麻疹和特应性皮炎）制定的严重哮喘统一定义方法推广应用，以便在大多数情况下能够统一严重程度、控制和风险的定义。这一定义基于适当的诊断、治疗方法的可获得性和可及性、治疗反应性以及合并症和危险因素等相关因素。这种统一的定义将有助于更好地定义严重过敏（和相关）疾病的表型，以用于临床实践、研究（包括流行病学）、公共卫生、教育和新型疗法的发现。
