Raherison C, Hamzaoui A, Nocent-Ejnaini C, Essari L-A, Ouksel H, Zysman M, Prudhomme A
Service des maladies respiratoires, pôle cardiothoracique, INSERM U1219, université de Bordeaux, CHU Bordeaux, 146, rue Léo-Saignat, 33604 Bordeaux, France.
Pavillon B, unité de recherche UR12 SP15, hôpital Abderrahmen Mami, faculté de médecine, université de Tunis El Manar, Ariana, Tunisie.
Rev Mal Respir. 2020 Feb;37(2):144-160. doi: 10.1016/j.rmr.2019.07.013. Epub 2020 Feb 10.
In a woman's life, asthma can affect her in a variety of ways, with the onset of premenstrual asthma currently under-diagnosed. It is estimated that about 20% of women with asthma have premenstrual asthma, which is more common in patients with severe asthma. Women with asthma are at high risk of exacerbations and of severe asthma. Asthma is the most common chronic disease during pregnancy with potential maternal and foetal complications. Asthma medications are safe for the foetus and it is essential to continue pre-existing treatment and adapt it to the progress of asthma during the pregnancy. Sex steroids modulate the structure and function of bronchial and immune cells. Understanding their role in asthma pathogenesis is complicated by the ambivalent effects of bronchodilating and pro-inflammatory oestrogens as well as the diversity of response to their association with progesterone. Menopausal asthma is a clinical entity and is part of one of the phenotypes of severe non-allergic and low steroid-sensitive asthma. Targeted assessment of the domestic and professional environment allows optimization of asthma management.
在女性的一生中，哮喘会以多种方式影响她们，目前经前哮喘的发病情况诊断不足。据估计，约20%的哮喘女性患有经前哮喘，在重度哮喘患者中更为常见。哮喘女性有病情加重和患重度哮喘的高风险。哮喘是孕期最常见的慢性病，存在潜在的母婴并发症。哮喘药物对胎儿是安全的，继续原有治疗并根据孕期哮喘进展进行调整至关重要。性类固醇调节支气管和免疫细胞的结构与功能。支气管扩张性雌激素和促炎性雌激素的矛盾作用以及它们与孕酮联合反应的多样性，使得了解它们在哮喘发病机制中的作用变得复杂。绝经后哮喘是一种临床实体，是重度非过敏性和低类固醇敏感性哮喘的一种表型。对家庭和职业环境进行针对性评估有助于优化哮喘管理。
