Respiratory & Immunology, Clinical Research, Merck Research Laboratories, Kenilworth, NJ 07033, USA.
Curr Opin Allergy Clin Immunol. 2013 Jun;13(3):225-36. doi: 10.1097/ACI.0b013e32836096de.
Asthma is a multifaceted disease that is associated with decreased lung function, multiple symptoms, varying levels of asthma control, and risk of acute exacerbations. The ability to predict the risk of developing acute exacerbations may improve the management of asthmatics and facilitate identification of these patients for interventional studies.
Factors that are associated with different manifestations of asthma differ. Biomarkers that are correlated with airways hyper-responsiveness do not necessarily correlate with risk of future exacerbations. Genetic factors that segregate with exacerbation risk are beginning to emerge. Outcome measures that demonstrate predictive validity have been developed and may facilitate patient management and provide novel clinically meaningful endpoints in clinical trials.
This review will emphasize underlying factors associated with asthma exacerbations and clinical prediction rules that correlate with the risk of developing severe exacerbations of asthma.
哮喘是一种多方面的疾病，与肺功能下降、多种症状、哮喘控制程度不同以及急性加重风险相关。预测发生急性加重的风险的能力可能会改善哮喘患者的管理，并有助于确定这些患者是否需要进行干预性研究。
与哮喘不同表现相关的因素不同。与气道高反应性相关的生物标志物不一定与未来加重的风险相关。与加重风险相关的遗传因素开始显现。已经开发出具有预测有效性的结局指标，这些指标可能有助于患者管理，并在临床试验中提供新的有临床意义的终点。
本综述将强调与哮喘加重相关的潜在因素和与发生严重哮喘加重风险相关的临床预测规则。
