Nagasaki Tadao, Matsumoto Hisako, Izuhara Kenji
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Allergol Int. 2017 Jul;66(3):404-410. doi: 10.1016/j.alit.2017.02.003. Epub 2017 Feb 28.
Type-2/eosinophilic inflammation plays a pivotal role in asthma. The identification of severe type-2/eosinophilic asthma is important for improving the management of patients with asthma. Therefore, efforts to develop non-invasive biomarkers for type-2/eosinophilic airway inflammation have been made during this decade. Currently, fraction of exhaled nitric oxide (FeNO) and serum periostin levels are considered markers of type-2/eosinophilic inflammation in asthma. However, a single-marker approach has limited the ability to diagnose severe type-2/eosinophilic asthma accurately and predict disease outcomes precisely. The present article reviews the utility of FeNO and serum periostin levels in a single-marker approach and in a multiple-marker approach in identifying patients with severe type-2/eosinophilic asthma. Furthermore, based on a sub-analysis of the Kinki Hokuriku Airway disease Conference (KiHAC), geno-endo-phenotypes of patients were stratified into four groups according to the FeNO and serum periostin levels.
2型/嗜酸性粒细胞炎症在哮喘中起关键作用。识别重度2型/嗜酸性粒细胞哮喘对于改善哮喘患者的管理至关重要。因此，在这十年中人们致力于开发用于2型/嗜酸性粒细胞气道炎症的非侵入性生物标志物。目前，呼出一氧化氮分数（FeNO）和血清骨膜蛋白水平被认为是哮喘中2型/嗜酸性粒细胞炎症的标志物。然而，单一标志物方法限制了准确诊断重度2型/嗜酸性粒细胞哮喘以及精确预测疾病转归的能力。本文综述了FeNO和血清骨膜蛋白水平在单一标志物方法和多标志物方法中用于识别重度2型/嗜酸性粒细胞哮喘患者的效用。此外，基于近畿北陆气道疾病会议（KiHAC）的亚分析，根据FeNO和血清骨膜蛋白水平将患者的基因-内表型分为四组。
