Heffler Enrico, Carpagnano Giovanna Elisiana, Favero Elisabetta, Guida Giuseppe, Maniscalco Mauro, Motta Andrea, Paoletti Giovanni, Rolla Giovanni, Baraldi Eugenio, Pezzella Vincenza, Piacentini Giorgio, Nardini Stefano
Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano (MI).
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI).
Multidiscip Respir Med. 2020 Feb 19;15(1):36. doi: 10.4081/mrm.2020.36. eCollection 2020 Jan 28.
Asthma prevalence in Italy is on the rise and is estimated to be over 6% of the general population. The diagnosis of asthma can be challenging and elusive, especially in children and the last two decades has brought evidences that asthma is not a single disease but consists of various phenotypes. Symptoms can be underestimated by the patient or underreported to the clinician and physical signs can be scanty. Usual objective measures, like spirometry, are necessary but sometimes not significant. Despite proper treatment, asthma can be a very severe condition (even leading to death), however new drugs have recently become available which can be very effective in its control. Since asthma is currently thought to be caused by inflammation, a direct measure of the latter can be of paramount importance. For this purpose, the measurement of Fractional Exhaled Nitric Oxide (FE) has been used since the early years of the current century as a non-invasive, easy-to-assess tool useful for diagnosing and managing asthma. This SIP-IRS/SIAAIC Position Paper is a narrative review which summarizes the evidence behind the usefulness of FE in the diagnosis, management and phenotypization of asthma.
意大利哮喘的患病率呈上升趋势，估计超过总人口的6%。哮喘的诊断可能具有挑战性且难以捉摸，尤其是在儿童中。在过去的二十年里，有证据表明哮喘不是单一疾病，而是由多种表型组成。症状可能被患者低估或未充分向临床医生报告，体征可能很少。常规的客观检测方法，如肺功能测定，是必要的，但有时并不显著。尽管进行了适当的治疗，哮喘仍可能是一种非常严重的疾病（甚至导致死亡），然而最近有了新的药物，这些药物在控制哮喘方面可能非常有效。由于目前认为哮喘是由炎症引起的，对炎症的直接检测可能至关重要。为此，自本世纪初以来，呼出一氧化氮分数（FE）的测量已被用作一种非侵入性、易于评估的工具，用于诊断和管理哮喘。本SIP-IRS/SIAAIC立场文件是一篇叙述性综述，总结了FE在哮喘诊断、管理和表型分析中的有用性背后的证据。
