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过敏性疾病和哮喘生物标志物的最新进展和研究亮点。

Recent developments and highlights in biomarkers in allergic diseases and asthma.

机构信息

Unidad de Alergia, IBIMA-Hospital Regional Universitario de Malaga-UMA, ARADyAL, Malaga, Spain.

Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore, Singapore.

出版信息

Allergy. 2018 Dec;73(12):2290-2305. doi: 10.1111/all.13628. Epub 2018 Oct 30.

Abstract

The potential of precision medicine in allergy and asthma has only started to be explored. A significant clarification in the pathophysiology of rhinitis, chronic rhinosinusitis, asthma, food allergy and drug hypersensitivity was made in the last decade. This improved understanding led to a better classification of the distinct phenotypes and to the discovery of new drugs such as biologicals, targeting phenotype-specific mechanisms. Nevertheless, many conditions remain poorly understood such as non-eosinophilic airway diseases or non-IgE-mediated food allergy. Moreover, there is a need to predict the response to specific therapies and the outcome of drug and food provocations. The identification of patients at risk of progression towards severity is also an unmet need in order to establish adequate preventive or therapeutic measures. The implementation of precision medicine in the clinical practice requires the identification of phenotype-specific markers measurable in biological matrices. To become useful, these biomarkers need to be quantifiable by reliable systems, and in samples obtained in an easy, rapid and cost-efficient way. In the last years, significant research resources have been put in the identification of valid biomarkers for asthma and allergic diseases. This review summarizes these recent advances with focus on the biomarkers with higher clinical applicability.

摘要

精准医学在过敏和哮喘中的应用潜力才刚刚开始被探索。在过去十年中,对鼻炎、慢性鼻-鼻窦炎、哮喘、食物过敏和药物超敏反应的病理生理学有了重大的澄清。这种理解的提高导致了对不同表型的更好分类,并发现了新的药物,如针对表型特异性机制的生物制剂。然而,仍有许多情况理解不佳,如非嗜酸性气道疾病或非 IgE 介导的食物过敏。此外,需要预测对特定治疗的反应以及药物和食物激发的结果。识别有进展为严重程度风险的患者也是一个未满足的需求,以便建立适当的预防或治疗措施。精准医学在临床实践中的实施需要识别可在生物基质中测量的表型特异性标志物。为了变得有用,这些生物标志物需要通过可靠的系统进行定量,并且可以通过简单、快速和具有成本效益的方式获得样本。在过去的几年中,已经投入了大量的研究资源来识别哮喘和过敏性疾病的有效生物标志物。这篇综述总结了这些最新进展,重点介绍了具有更高临床适用性的生物标志物。

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