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预防哮喘:干预靶点。

Prevention of Asthma: Targets for Intervention.

机构信息

Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA.

Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA.

出版信息

Chest. 2020 Sep;158(3):913-922. doi: 10.1016/j.chest.2020.04.011. Epub 2020 Apr 21.

Abstract

Approximately 300 million people worldwide are estimated to be affected by asthma, and the number of patients affected is growing exponentially-with potential for an additional 100 million people affected by the condition by 2025. With this increasing burden of disease, there is high motivation to discover effective prevention strategies. Strategies aimed at stalling the atopic progression, modifying the microbiome, preventing respiratory viral infections, and reducing the impact of toxin/pollutant exposure through dietary supplements have had limited success in the prevention of asthma. This is likely because asthma is heterogenous and is influenced by different genetic and environmental factors. Genes underlie a predisposition to asthma and allergic sensitization, whereas exposure to allergens, respiratory infections, and pollution may modify asthma pathogenesis and the variation in severity seen among individuals. Future advances in asthma prevention may include a more personalized approach: genetic variations among susceptible individuals with distinct asthma phenotypes or different biomarkers of disease may help individualize prevention strategies and render them more . In this article, we summarize interventions that have been studied for the prevention of asthma and identify some of the clinical trials that are actively underway in asthma prevention.

摘要

据估计,全球有大约 3 亿人受到哮喘的影响,而且受影响的患者人数正在呈指数级增长——到 2025 年,预计将有另外 1 亿人受到该疾病的影响。随着疾病负担的增加,人们强烈希望发现有效的预防策略。旨在阻止特应性进展、改变微生物组、预防呼吸道病毒感染以及通过膳食补充剂减少毒素/污染物暴露影响的策略,在预防哮喘方面的成功有限。这可能是因为哮喘具有异质性,并且受到不同遗传和环境因素的影响。基因导致哮喘和过敏敏化的易感性,而接触过敏原、呼吸道感染和污染可能会改变哮喘的发病机制,并导致个体之间严重程度的差异。哮喘预防的未来进展可能包括更个性化的方法:具有不同哮喘表型或不同疾病生物标志物的易感个体中的基因变异可能有助于个体化预防策略,并使它们更具。在本文中,我们总结了已经研究过的用于预防哮喘的干预措施,并确定了一些正在进行中的哮喘预防临床试验。

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