Department of Clinical and Experimental Medicine, A.O.U. Policlinico - Vittorio Emanuele, Università degli Studi di Catania, Via S. Sofia, 78, 95123, Catania, Italy.
Royal Brompton and Harefield Hospital NHS Trust, London, UK.
Intern Emerg Med. 2018 Mar;13(2):155-176. doi: 10.1007/s11739-017-1773-y. Epub 2017 Dec 14.
Asthma is a chronic inflammatory multifactorial disorder of the airways characterized by the involvement of immune cells and mediators in its onset and maintenance. Traditional therapeutic strategies have been unsatisfactory in controlling the underlying pathology, especially in the more severe states. Hence in the last couple of decades, new biological approaches targeting molecular mediators have been developed. In this narrative review we examine biological agents currently available for the management of severe asthma, focusing our attention on their clinical application, pros and cons, and in particular on gaps regarding the use of these agents. The most well-known and used biologic agent in clinical practice is omalizumab, though there is emerging evidence for mepolizumab too. The future of these biological therapies is to broaden our knowledge of their practical use and ascertain predictive biomarkers, or define an algorithm, useful in the optimal application of these 'biological weapons'.
哮喘是一种气道慢性炎症性多因素疾病，其发生和维持涉及免疫细胞和介质。传统的治疗策略在控制潜在病理方面并不令人满意，尤其是在更严重的情况下。因此，在过去的几十年中，已经开发出了针对分子介质的新型生物治疗方法。在本叙述性综述中，我们检查了目前可用于治疗严重哮喘的生物制剂，重点关注它们的临床应用、优缺点，特别是在这些制剂的使用方面存在的差距。在临床实践中使用最广泛和最著名的生物制剂是奥马珠单抗，但美泊利珠单抗也有新的证据。这些生物疗法的未来是拓宽我们对其实际应用的了解，并确定预测生物标志物，或定义一个算法，以有效地应用这些“生物武器”。
