The University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, M23 9LT, UK.
Expert Rev Respir Med. 2012 Jun;6(3):301-8. doi: 10.1586/ers.12.24.
Asthma is a complex multifactorial disorder involving a variety of different mechanisms. Little has changed in asthma treatment over the past five decades. There is evidence for a strong genetic component of asthma, but genetic studies have produced heterogeneous results with little replication, with most of the heritability remaining unexplained. The rapid increase in asthma prevalence over a short time period suggests that environmental exposures play an important role, but there is a considerable heterogeneity in the results describing the effect of different environmental exposures. There are many reasons for the lack of replication in genetic association studies and those of environmental exposures. These include the failure to consider that asthma may arise as a consequence of environmental factors, modulating the risk in genetically susceptible individuals via gene-environment interactions. In addition, many studies rely on oversimplified phenotypes often derived through aggregation of several heterogeneous conditions (e.g., 'physician-diagnosed asthma').
哮喘是一种复杂的多因素疾病，涉及多种不同的机制。在过去的五十年中，哮喘的治疗方法几乎没有改变。有证据表明哮喘有很强的遗传成分，但遗传研究的结果具有异质性，且重复性差，大部分遗传仍无法解释。在短时间内哮喘患病率的迅速增加表明环境暴露起着重要作用，但描述不同环境暴露影响的结果存在相当大的异质性。遗传关联研究和环境暴露研究缺乏重复性有很多原因。其中包括没有考虑到哮喘可能是环境因素导致的后果，通过基因-环境相互作用调节遗传易感个体的风险。此外，许多研究依赖于过于简化的表型，这些表型通常是通过聚合几种异质条件（例如，“医生诊断的哮喘”）得出的。
