Oksel Ceyda, Custovic Adnan
Department of Paediatrics, Imperial College London, London, UK.
Curr Opin Allergy Clin Immunol. 2018 Apr;18(2):109-116. doi: 10.1097/ACI.0000000000000430.
The purpose of this review is to summarize the recent evidence on the distinct atopic phenotypes and their relationship with childhood asthma. We start by considering definitions and phenotypic classification of atopy and then review evidence on its association with asthma in children.
It is now well recognized that both asthma and atopy are complex entities encompassing various different sub-groups that also differ in the way they interconnect. The lack of gold standards for diagnostic markers of atopy and asthma further adds to the existing complexity over diagnostic accuracy and definitions. Although recent statistical phenotyping studies contributed significantly to our understanding of these heterogeneous disorders, translating these findings into meaningful information and effective therapies requires further work on understanding underpinning biological mechanisms.
The disaggregation of allergic sensitization may help predict how the allergic disease is likely to progress. One of the important questions is how best to incorporate tests for the assessment of allergic sensitization into diagnostic algorithms for asthma, both in terms of confirming asthma diagnosis, and the assessment of future risk.
本综述旨在总结近期关于特应性不同表型及其与儿童哮喘关系的证据。我们首先考虑特应性的定义和表型分类,然后回顾其与儿童哮喘关联的证据。
目前已充分认识到,哮喘和特应性都是复杂的实体,包含各种不同的亚组,这些亚组在相互联系的方式上也存在差异。缺乏特应性和哮喘诊断标志物的金标准,进一步增加了诊断准确性和定义方面现有的复杂性。尽管近期的统计表型研究对我们理解这些异质性疾病有很大帮助,但要将这些发现转化为有意义的信息和有效的治疗方法,还需要进一步研究其潜在的生物学机制。
过敏性致敏的分解可能有助于预测过敏性疾病的发展趋势。一个重要问题是,如何最好地将评估过敏性致敏的检测纳入哮喘诊断算法,包括确认哮喘诊断以及评估未来风险。