Institute for Lung Health, Department of Infection, Immunity and Inflammation, The University of Leicester, United Kingdom.
Ann Am Thorac Soc. 2013 Dec;10 Suppl:S214-9. doi: 10.1513/AnnalsATS.201302-023AW.
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease. COPD exacerbations have a major impact on morbidity and mortality. The etiology of COPD exacerbations is largely due to viral and bacterial infections in combination with underlying inflammation that is typically neutrophilic, although it is eosinophilic in 10 to 25% of cases. We review the recent studies that have defined novel biological clusters at exacerbation events and consequently identified important biomarkers to direct therapy. These biomarkers include C-reactive protein, procalcitonin, and peripheral blood eosinophil count, which are readily available. We are therefore at a point of making personalized antibiotic and corticosteroid therapy in COPD exacerbations a reality. Integration of the wealth of emerging data to further define the complexity of exacerbations also promises to identify new targets and biomarkers to treat COPD exacerbations.
慢性阻塞性肺疾病（COPD）是一种异质性疾病。COPD 加重对发病率和死亡率有重大影响。COPD 加重的病因主要是病毒和细菌感染，加上潜在的炎症，通常是中性粒细胞性的，但在 10%至 25%的病例中是嗜酸性粒细胞性的。我们回顾了最近的研究，这些研究在加重事件中定义了新的生物学聚类，并因此确定了重要的生物标志物来指导治疗。这些生物标志物包括 C 反应蛋白、降钙素原和外周血嗜酸性粒细胞计数，这些都是易于获得的。因此，我们正处在使 COPD 加重的个体化抗生素和皮质类固醇治疗成为现实的阶段。整合大量新兴数据以进一步定义加重的复杂性，也有望确定新的靶点和生物标志物来治疗 COPD 加重。
