Medical University of Lodz, Poland.
J Intern Med. 2012 Aug;272(2):121-32. doi: 10.1111/j.1365-2796.2012.02558.x.
Asthma is a global health problem affecting around 300 million patients of all ages and ethnic groups in all countries around the world. In the majority of subjects with persistent, mild-to-moderate asthma (MA), the disease can be relatively well controlled by the use of currently available medications; however, five to ten per cent of patients suffer from a particularly severe disease that is poorly controlled clinically and often refractory to usual treatment. Improved care of severe asthma (SA) is a major unmet medical need and several international consortia aim at improving our understanding of mechanisms in SA. To manage SA better, standardized definitions and concepts of asthma severity, risk and level of control are critical. In the following sections, we present several guidelines approaches and definitions followed by an overview of U.S. (SARP) and European (ENFUMOSA, BIOAIR, U-BIOPRED) SA networks. Key findings regarding SA phenotypes, risk factors and pathophysiology are discussed. International cooperation in the area of respiratory diseases, including SA, across the Atlantic Ocean, will lead to a better understanding of asthma pathology, especially of those severe, not well controlled or difficult-to-treat cases.
哮喘是一个全球性的健康问题，影响着全球所有国家各个年龄段和种族的约 3 亿患者。在大多数持续性、轻度至中度哮喘（MA）患者中，目前可用的药物可以使疾病得到较好的控制；然而，5%至 10%的患者患有一种特别严重的疾病，其临床控制较差，且通常对常规治疗有抗性。改善严重哮喘（SA）的治疗是一个主要的未满足的医疗需求，几个国际联盟旨在提高我们对 SA 机制的理解。为了更好地管理 SA，严重程度、风险和控制水平的标准化定义和概念至关重要。在以下各节中，我们介绍了几种指南方法和定义，随后概述了美国（SARP）和欧洲（ENFUMOSA、BIOAIR、U-BIOPRED）SA 网络。讨论了关于 SA 表型、风险因素和病理生理学的主要发现。跨越大西洋，在呼吸疾病领域，包括 SA，开展国际合作将有助于更好地了解哮喘的病理生理学，尤其是那些严重、控制不佳或难以治疗的病例。
