University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Groningen, Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands.
Pharmacol Ther. 2019 Sep;201:8-24. doi: 10.1016/j.pharmthera.2019.05.002. Epub 2019 May 8.
Asthma is a chronic respiratory condition, which is highly prevalent worldwide. Although no cure is currently available, it is well recognized that some asthma patients can spontaneously enter remission of the disease later in life. Asthma remission is characterized by absence of symptoms and lack of asthma-medication use. Subjects in asthma remission can be divided into two groups: those in clinical remission and those in complete remission. In clinical asthma remission, subjects still have a degree of lung functional impairment or bronchial hyperresponsiveness, while in complete asthma remission, these features are no longer present. Over longer periods, the latter group is less likely to relapse. This remission group is of great scientific interest due to the higher potential to find biomarkers or biological pathways that elicit or are associated with asthma remission. Despite the fact that the definition of asthma remission varies between studies, some factors are reproducibly observed to be associated with remitted asthma. Among these are lower levels of inflammatory markers, which are lowest in complete remission. Additionally, in both groups some degree of airway remodeling is present. Still, the pathological disease state of asthma remission has been poorly investigated. Future research should focus on at least two aspects: further characterisation of the small airways and airway walls in order to determine histologically true remission, and more thorough biological pathway analyses to explore triggers that elicit this phenomenon. Ultimately, this will result in pharmacological targets that provide the potential to steer the course of asthma towards remission.
哮喘是一种慢性呼吸系统疾病，在全球范围内发病率很高。虽然目前尚无治愈方法，但人们普遍认识到，一些哮喘患者在以后的生活中可以自发地进入疾病缓解期。哮喘缓解期的特征是没有症状，也不使用哮喘药物。处于哮喘缓解期的患者可以分为两组：临床缓解组和完全缓解组。在临床哮喘缓解中，患者的肺功能仍有一定程度的损害或支气管高反应性，而在完全哮喘缓解中，这些特征不再存在。在较长时间内，后者组不太可能复发。由于有更高的潜力发现引发或与哮喘缓解相关的生物标志物或生物学途径，因此这个缓解组具有很大的科学意义。尽管哮喘缓解的定义在不同的研究中有所不同，但一些因素被反复观察到与缓解的哮喘有关。其中包括炎症标志物水平较低，在完全缓解中最低。此外，在这两个组中，都存在一定程度的气道重塑。然而，哮喘缓解的病理疾病状态仍未得到充分研究。未来的研究应至少集中在两个方面：进一步描述小气道和气道壁的特征，以确定组织学上真正的缓解，以及更彻底的生物学途径分析，以探讨引发这种现象的触发因素。最终，这将为提供潜在的治疗方法提供药理学靶点，以引导哮喘走向缓解。
