哮喘、荨麻疹和鼻息肉的生物制剂和生物标志物。

Biologics and biomarkers for asthma, urticaria, and nasal polyposis.

机构信息

Department of Internal Medicine, Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla.

出版信息

J Allergy Clin Immunol. 2017 May;139(5):1411-1421. doi: 10.1016/j.jaci.2017.03.006.

Abstract

Many patients with allergic disorders continue to have uncontrolled symptoms despite new and better pharmacologic options. Novel biologic agents that target specific and critical pathophysiologic pathways have been developed to better manage these patients. The utility of biologic agents for the management of allergic diseases has been facilitated by recent advances in better characterizing patients, including identification of relevant biomarkers that predict clinical responsiveness. This has led to the ability to phenotype and endotype patients, allowing for a more rational approach to picking a specific biologic agent for a specific patient. In this review I focus on point-of-care biomarkers that enhance the usefulness of biologics to manage uncontrolled asthma, urticaria, and nasal polyposis. I discuss biologic agents already approved for the management of allergic and respiratory disorders and biologics currently in development or recently abandoned because of a lack of efficacy or intolerable side effects. The successes and failures of biologics in clinical trials have facilitated our ability to better understand which molecules and pathways are most important in the pathogenesis of allergic diseases and in the development of symptoms and impairment in individual patients.

摘要

尽管有新的、更好的药物选择,但许多过敏疾病患者的症状仍未得到控制。为了更好地治疗这些患者,已经开发出了针对特定关键病理生理途径的新型生物制剂。生物制剂在治疗过敏疾病中的应用得益于最近在更好地描述患者方面的进展,包括确定预测临床反应的相关生物标志物。这使得对患者进行表型和内型分类成为可能,从而可以更合理地为特定患者选择特定的生物制剂。在这篇综述中,我重点介绍了一些即时检测生物标志物,这些标志物增强了生物制剂在管理未控制的哮喘、荨麻疹和鼻息肉方面的效用。我讨论了已经批准用于治疗过敏和呼吸道疾病的生物制剂,以及目前正在开发或因疗效不佳或不可耐受的副作用而被放弃的生物制剂。生物制剂在临床试验中的成功和失败使我们能够更好地理解哪些分子和途径在过敏疾病的发病机制以及在个体患者症状和功能障碍的发展中最为重要。

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