Department for Internal Medicine I, University Hospital Schleswig-Holstein Campus Kiel Airway Research Center North (ARCN), German Center for Lung Research (DZL), Germany Nordic Bioscience A/S, Herlev, Denmark Department of Pediatric Pulmonology and Allergology, University Children's Hospital, Lübeck, Germany.
Curr Opin Pulm Med. 2020 Jan;26(1):40-46. doi: 10.1097/MCP.0000000000000641.
'Biomarkers of remodeling' represent a loose collection of features referring to several biological adaptations of the lung to cope with stressing factors. In addition, remodel-'ing' infers a dynamic process that would require a spatiotemporal resolution. This review focuses on different aspects of remodeling in pediatric and adult care.
This review will cover aspects of pediatric remodeling, adult remodeling and techniques and procedures to adequately assess remodeling across different age spectra. In pediatrics, the onset and first features of remodeling are discussed and the continuation into adolescence is addressed. For adults, this review addresses predominant features of remodeling throughout the adult life span and whether there are currently interventions available to treat or reverse remodeling.
The term 'remodeling' is often referred to via biomarkers that reflect the endstage of a process, although it rather reflects a continuous process starting in childhood and progressing to all age-levels in patients with asthma. Hence, only few biomarkers or surrogates are able to 'capture' its spatiotemporal component, and hardly any are ready for routine use in clinical practice. Given the clinical impact of the remodeling processes, new biomarkers are needed to adequately treat patients with asthma and objectively monitor treatment response beyond symptom control and lung function.
“重塑生物标志物”是指一系列松散的特征，这些特征涉及肺对压力因素的几种生物学适应。此外，“重塑”意味着一个动态的过程，需要时空分辨率。本综述重点介绍儿科和成人护理中重塑的不同方面。
本综述将涵盖儿科重塑、成人重塑以及在不同年龄范围内评估重塑的技术和程序的各个方面。在儿科领域，讨论了重塑的开始和最初特征，并探讨了其在青春期的延续。对于成年人，本综述探讨了整个成年期重塑的主要特征，以及目前是否有可用的干预措施来治疗或逆转重塑。
“重塑”一词通常通过反映该过程终末期的生物标志物来提及，尽管它反映的是一个从儿童期开始并逐渐进展到哮喘患者所有年龄段的连续过程。因此，只有少数生物标志物或替代物能够“捕捉”其时空成分，而且几乎没有任何生物标志物或替代物可用于临床实践中的常规使用。鉴于重塑过程的临床影响，需要新的生物标志物来充分治疗哮喘患者，并在症状控制和肺功能之外客观地监测治疗反应。
