George Leena, Brightling Christopher E
Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Department of Infection, Immunity and Inflammation, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK.
Institute for Lung Health, Clinical Science Wing, University Hospital of Leicester, Leicester LE3 9QP, UK.
Ther Adv Chronic Dis. 2016 Jan;7(1):34-51. doi: 10.1177/2040622315609251.
The chronic lung diseases, asthma and chronic obstructive pulmonary disease (COPD), are common affecting over 500 million people worldwide and causing substantial morbidity and mortality. Asthma is typically associated with Th2-mediated eosinophilic airway inflammation, in contrast to neutrophilic inflammation observed commonly in COPD. However, there is increasing evidence that the eosinophil might play an important role in 10-40% of patients with COPD. Consistently in both asthma and COPD a sputum eosinophilia is associated with a good response to corticosteroid therapy and tailored strategies aimed to normalize sputum eosinophils reduce exacerbation frequency and severity. Advances in our understanding of the multistep paradigm of eosinophil recruitment to the airway, and the consequence of eosinophilic inflammation, has led to the development of new therapies to target these molecular pathways. In this article we discuss the mechanisms of eosinophilic trafficking, the tools to assess eosinophilic airway inflammation in asthma and COPD during stable disease and exacerbations and review current and novel anti-eosinophilic treatments.
慢性肺部疾病，如哮喘和慢性阻塞性肺疾病（COPD），十分常见，全球有超过5亿人受其影响，并导致大量发病和死亡。哮喘通常与Th2介导的嗜酸性粒细胞性气道炎症相关，这与COPD中常见的中性粒细胞炎症形成对比。然而，越来越多的证据表明，嗜酸性粒细胞可能在10%至40%的COPD患者中发挥重要作用。在哮喘和COPD中，痰嗜酸性粒细胞增多均与对皮质类固醇治疗的良好反应相关，旨在使痰嗜酸性粒细胞正常化的针对性策略可降低急性加重的频率和严重程度。我们对嗜酸性粒细胞募集到气道的多步骤模式以及嗜酸性粒细胞炎症后果的理解取得了进展，这促使开发针对这些分子途径的新疗法。在本文中，我们讨论嗜酸性粒细胞转运的机制、评估哮喘和COPD稳定期疾病及急性加重期嗜酸性粒细胞性气道炎症的工具，并综述当前和新型抗嗜酸性粒细胞治疗方法。
