Kao Christina C, Parulekar Amit D
Section of Pulmonary, Critical Care, and Sleep, Department of Medicine, Baylor College of Medicine, Houston, TX, USA,
J Asthma Allergy. 2019 Jan 3;12:1-5. doi: 10.2147/JAA.S167973. eCollection 2019.
Asthma is a heterogeneous disease, which may be classified into phenotypes and endotypes based on clinical characteristics and molecular mechanisms. The best described endotype of severe asthma is type 2 (T2)-high asthma, characterized by release of inflammatory cytokines by T helper 2 (T2) cells and type 2 innate lymphoid cells cells. Prostaglandin D2 contributes to T2 inflammation through binding of the G-protein-coupled receptor chemoattractant receptor-homologous molecule expressed on T2 cells (CRTH2). Fevipiprant is an oral competitive antagonist of CRTH2. Early-phase trials have demonstrated safety and potential efficacy in patients with asthma, specifically, improvement in FEV and eosinophilic airway inflammation. However, no clear biomarker identified patients who responded favorably to fevipiprant, although patients with moderate-to-severe asthma and evidence of T2 inflammation may be more likely to respond to treatment. Additional studies are needed to determine the efficacy and target population for use of this drug in patients with asthma.
哮喘是一种异质性疾病，可根据临床特征和分子机制分为不同的表型和内型。重度哮喘中描述得最为清楚的内型是2型（T2）高哮喘，其特征是辅助性T2（T2）细胞和2型固有淋巴细胞释放炎性细胞因子。前列腺素D2通过与T2细胞上表达的G蛋白偶联受体趋化因子受体同源分子（CRTH2）结合，促进T2炎症反应。非维普兰特是一种口服CRTH2竞争性拮抗剂。早期试验已证明其对哮喘患者具有安全性和潜在疗效，特别是对第一秒用力呼气容积（FEV）和嗜酸性气道炎症有改善作用。然而，尽管中重度哮喘且有T2炎症证据的患者可能更有可能对治疗产生反应，但尚无明确的生物标志物能识别出对非维普兰特反应良好的患者。需要进行更多研究以确定该药物在哮喘患者中的疗效和适用人群。
