Intensive Care Unit, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Bosn J Basic Med Sci. 2019 Nov 8;19(4):315-320. doi: 10.17305/bjbms.2019.3977.
Pneumonia is the leading infectious cause of death worldwide. While inflammation is critically important in host response to microbial invasion, exaggerated inflammation can damage the lungs, contributing to respiratory failure and mortality. Corticosteroids are effective in reducing inflammation and can also cause immune suppression. Presently, clinicians are unable to reliably distinguish between exaggerated and appropriate immune response and thus cannot rapidly identify patients most likely to benefit from adjunctive corticosteroids. In this review, we propose a biomarker-guided, precision medicine approach to corticosteroid treatment, aimed to give these medications at appropriate dose and time and only to patients who have exaggerated inflammation.
肺炎是全球范围内导致死亡的主要感染性病因。尽管炎症在宿主抵御微生物入侵的过程中起着至关重要的作用，但过度的炎症反应可损伤肺部，导致呼吸衰竭和死亡。皮质类固醇在减轻炎症反应方面具有确切疗效，但同时也可导致免疫抑制。目前，临床医生无法可靠地区分过度和适当的免疫反应，因此无法迅速识别最有可能从皮质类固醇辅助治疗中获益的患者。在本综述中，我们提出了一种基于生物标志物的精准医学方法来指导皮质类固醇治疗，旨在给予合适剂量和时间的皮质类固醇药物，并仅用于存在过度炎症的患者。
