T2-“低”度哮喘：概述与管理策略。
T2-"Low" Asthma: Overview and Management Strategies.
机构信息
Emory University Department of Pediatrics, Atlanta, Ga.
Capital Allergy and Respiratory Disease Center, Sacramento, Calif.
出版信息
J Allergy Clin Immunol Pract. 2020 Feb;8(2):452-463. doi: 10.1016/j.jaip.2019.11.006.
Although the term "asthma" has been applied to all patients with airway lability and variable chest symptoms for centuries, phenotypes of asthma with distinct clinical and molecular features that may warrant different treatment approaches are well recognized. Patients with type 2 (T2)-"high" asthma are characterized by upregulation of T2 immune pathways (ie, IL-4 and IL-13 gene sets) and eosinophilic airway inflammation, whereas these features are absent in patients with T2-"low" asthma and may contribute to poor responsiveness to corticosteroid treatment. This review details definitions and clinical features of T2-"low" asthma, potential mechanisms and metabolic aspects, pediatric considerations, and potential treatment approaches. Priority research questions for T2-"low" asthma are also discussed.
尽管“哮喘”这一术语在几个世纪以来一直被用于所有气道高反应性和可变胸部症状的患者，但具有不同临床和分子特征的哮喘表型已得到充分认识，这些表型可能需要不同的治疗方法。2 型（T2）“高”哮喘患者的特点是 T2 免疫途径（即 IL-4 和 IL-13 基因集）上调和嗜酸性气道炎症，而 T2-“低”哮喘患者不存在这些特征，并且可能导致对皮质类固醇治疗反应不佳。本文详细介绍了 T2-“低”哮喘的定义和临床特征、潜在机制和代谢方面、儿科考虑因素以及潜在的治疗方法。还讨论了 T2-“低”哮喘的优先研究问题。
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