Center for Environmental Medicine, Asthma and Lung Biology, UNC Chapel Hill, Chapel Hill, North Carolina, USA.
Curr Opin Pulm Med. 2014 Jan;20(1):46-52. doi: 10.1097/MCP.0000000000000010.
Although there are several known methods by which to sample the upper and lower airways in asthmatic patients, new endpoints have emerged over the past few years from these sampling techniques that may be useful biomarkers. It is both timely and relevant that these endpoints be reviewed in the context of their role in asthma and hence as potential biomarkers in asthma.
This article will cover various upper and lower airway sampling methods, and the standard and specialized endpoints that can be derived from those methods. For the nasal airways, this will include nasal lavage, exhaled nasal nitric oxide and acoustic rhinometry. For the lower airways this will include induced sputum, bronchoscopy-based methods and exhaled breath.
Some methodologies such as bronchoscopy remain limited in their widespread clinical application due to their invasive nature. Less invasive techniques such as electronic nose and breath condensate have potential biomarker application but still require standardization and additional study. It is clear, however, that despite the applicability of a given sampling technique, both routine (cells and cytokines) and specialized (genomic, phenotypic, hydration) endpoints are measurable and should be combined in clinical trial studies to yield maximum results in asthma.
尽管有几种已知的方法可以对哮喘患者的上、下呼吸道进行采样，但近年来，这些采样技术出现了一些新的终点，它们可能是有用的生物标志物。在哮喘的背景下，以及作为哮喘的潜在生物标志物，对这些终点进行回顾是及时且相关的。
本文将涵盖各种上、下呼吸道采样方法，以及可从这些方法中得出的标准和特殊终点。对于鼻气道，这将包括鼻冲洗、呼出气一氧化氮和鼻声反射测量。对于下呼吸道，这将包括诱导痰、支气管镜检查法和呼出气。
由于某些方法具有侵袭性，如支气管镜检查，因此其在广泛的临床应用中受到限制。电子鼻和呼吸冷凝物等微创技术具有潜在的生物标志物应用，但仍需要标准化和进一步研究。然而，很明显，尽管给定的采样技术具有适用性，但常规（细胞和细胞因子）和特殊（基因组、表型、水合作用）终点都是可测量的，并且应该在临床试验研究中结合起来，以在哮喘中获得最大的结果。
