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哮喘的新疗法:从前列腺素 D 的致病作用到 fevipiprant 的治疗效果。

New treatments for asthma: From the pathogenic role of prostaglandin D to the therapeutic effects of fevipiprant.

机构信息

Department of Medical and Surgical Sciences, University "Magna Græcia" of Catanzaro, Catanzaro, Italy.

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

出版信息

Pharmacol Res. 2020 May;155:104490. doi: 10.1016/j.phrs.2019.104490. Epub 2019 Nov 1.

Abstract

Prostaglandin D (PGD) is a pleiotropic mediator, significantly involved in the pathogenesis of type 2 (T2) asthma because of its biologic actions exerted on both immune/inflammatory and airway structural cells. In particular, the pro-inflammatory and pro-remodelling effects of PGD are mainly mediated by stimulation of chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2). This receptor is the target of the oral competitive antagonist fevipiprant, which on the basis of recent phase II studies is emerging as a potential very promising anti-asthma drug. Indeed, fevipiprant appears to be safe and effective, especially in consideration of its ability to inhibit eosinophilic bronchial inflammation and improve forced expiratory volume in one second (FEV). Further ongoing phase III trials will definitely clarify if fevipiprant can prospectively become a valid option for an efficacious add-on treatment of moderate-to-severe T2-high asthma.

摘要

前列腺素 D(PGD)是一种多效介质,由于其对免疫/炎症和气道结构细胞的生物学作用,在 2 型(T2)哮喘的发病机制中起重要作用。特别是 PGD 的促炎和促重塑作用主要通过刺激 Th2 细胞上表达的趋化因子受体同源分子(CRTH2)来介导。该受体是口服竞争性拮抗剂 fevipiprant 的靶标,基于最近的 II 期研究,它作为一种有前途的潜在抗哮喘药物正在出现。事实上,fevipiprant 似乎是安全有效的,尤其是考虑到它抑制嗜酸性粒细胞性支气管炎症和改善一秒用力呼气量(FEV)的能力。正在进行的进一步 III 期试验将明确 fevipiprant 是否可能成为中重度 T2 高哮喘有效附加治疗的有效选择。

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