Darveaux Jared, Busse William W
Department of Medicine, Section of Allergy Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
Department of Medicine, Section of Allergy Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
J Allergy Clin Immunol Pract. 2015 Mar-Apr;3(2):152-60; quiz 161. doi: 10.1016/j.jaip.2014.09.014.
Asthma is a multifaceted disease and is associated with significant impairment and risk, and a therapeutic response that is highly variable. Although current treatments are usually effective for patients with mild-to-moderate disease, patients with more severe asthma are often unresponsive to current efforts, and there remains a need for agents with properties that may achieve control in these individuals. There is ongoing research to identify bioactive molecules that contribute to the pathophysiology of asthma, and many of these have been identified as potential therapeutic targets to improve control of this disease. As a consequence of these efforts, monoclonal antibodies have been developed and tested as to their effectiveness in the treatment of asthma. The assessment of these new treatments has identified particular pathways that, in selected patients, have shown benefit. The following review will discuss the current and future use of biological agents for the treatment of asthma, their efficacy, and how certain patient phenotypes and endotypes may be associated with biomarkers that may be used to select treatments to achieve greatest effectiveness of their use. As knowledge of the effects of these biological agents in asthma emerges, as well as the patients in whom they are most beneficial, the movement toward personalized treatment will follow.
哮喘是一种多方面的疾病，与严重的功能损害和风险相关，且治疗反应高度可变。尽管目前的治疗方法通常对轻至中度疾病患者有效，但重度哮喘患者往往对当前的治疗措施无反应，因此仍需要具有可能实现对这些个体进行控制特性的药物。目前正在进行研究以确定导致哮喘病理生理学的生物活性分子，其中许多已被确定为改善该疾病控制的潜在治疗靶点。由于这些努力，单克隆抗体已被开发并测试其在哮喘治疗中的有效性。对这些新治疗方法的评估确定了特定的途径，在特定患者中已显示出益处。以下综述将讨论生物制剂在哮喘治疗中的当前和未来应用、它们的疗效，以及某些患者表型和内型如何可能与可用于选择治疗方法以实现其最大疗效的生物标志物相关联。随着对这些生物制剂在哮喘中的作用以及最受益患者的了解不断增加，个性化治疗将随之而来。
