Kim Byung Keun, Park So Young, Ban Ga Young, Kim Mi Ae, Lee Ji Hyang, An Jin, Shim Ji Su, Lee Youngsoo, Won Ha Kyeong, Lee Hwa Young, Sohn Kyoung Hee, Kang Sung Yoon, Park So Young, Lee Hyun, Kim Min Hye, Kwon Jae Woo, Yoon Sun Young, Lee Jae Hyun, Rhee Chin Kook, Moon Ji Yong, Lee Taehoon, Kim So Ri, Park Jong Sook, Kim Sang Heon, Park Heung Woo, Jeong Jae Won, Kim Sang Hoon, Koh Young Il, Oh Yeon Mok, Jang An Soo, Yoo Kwang Ha, Cho You Sook
Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Allergy Asthma Immunol Res. 2020 Nov;12(6):910-933. doi: 10.4168/aair.2020.12.6.910.
Severe asthma (SA) presents in about 3%-5% of adult asthmatics and is responsible for over 60% of asthma-related medical expenses, posing a heavy socioeconomic burden. However, to date, a precise definition of or clear diagnostic criteria for SA have not been established, and therefore, it has been challenging for clinicians to diagnose and treat this disease. Currently, novel biologics targeting several molecules, such as immunoglobulin E, interleukin (IL)5, and IL4/IL13, have emerged, and many new drugs are under development. These have brought a paradigm shift in understanding the mechanism of SA and have also provided new treatment options. However, we need to agree on a precise definition of and its diagnostic criteria for SA. Additionally, it is necessary to explain the diagnostic criteria and to summarize current standard and additional treatment options. This review is an experts' opinion on SA from the Korean Academy of Asthma, Allergy, and Clinical Immunology, the Working Group on Severe Asthma, and aims to provide a definition of and diagnostic criteria for SA, and propose future direction for SA diagnosis and management in Korea.
重度哮喘（SA）在约3%-5%的成年哮喘患者中出现，占哮喘相关医疗费用的60%以上，造成沉重的社会经济负担。然而，迄今为止，尚未确立SA的精确定义或明确的诊断标准，因此，临床医生对该疾病进行诊断和治疗一直具有挑战性。目前，针对几种分子的新型生物制剂已经出现，如免疫球蛋白E、白细胞介素（IL）-5和IL-4/IL-13，并且许多新药正在研发中。这些已经在对SA机制的理解上带来了范式转变，也提供了新的治疗选择。然而，我们需要就SA的精确定义及其诊断标准达成一致。此外，有必要解释诊断标准并总结当前的标准和额外的治疗选择。本综述是韩国哮喘、过敏和临床免疫学会重度哮喘工作组对SA的专家意见，旨在提供SA的定义和诊断标准，并提出韩国SA诊断和管理的未来方向。
