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变应原支气管激发试验:支持精准医学的重要研究工具。

Allergen bronchoprovocation test: an important research tool supporting precision medicine.

机构信息

Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec Heart and Lung Institute, Université Laval, Québec, Canada.

QPS-Netherlands, Groningen, The Netherlands.

出版信息

Curr Opin Pulm Med. 2021 Jan;27(1):15-22. doi: 10.1097/MCP.0000000000000742.

Abstract

PURPOSE OF REVIEW

Allergen bronchoprovocation test (ABT) has been used to study asthma pathophysiology and as a disease-modelling tool to assess the properties and efficacy of new asthma drugs. In view of the complexity and heterogeneity of asthma, which has driven the definition of several phenotypes and endotypes, we aim to discuss the role of ABT in the era of precision medicine and provide guidance for clinicians how to interpret and use available data to understand the implications for the benefits of asthma treatment.

RECENT FINDINGS

In this review, we summarize background knowledge and applications of ABT and provide an update with recent publications on this topic. In the past years, several studies have been published on ABT in combination with non-invasive and invasive airway samplings and innovative detection techniques allowing to study several inflammatory mechanisms linked to Th2-pathway and allergen-induced pathophysiology throughout the airways.

SUMMARY

ABT is a valuable research tool, which has strongly contributed to precision medicine by helping to define allergen-triggered key inflammatory pathways and airway pathophysiology, and thus helped to shape our understanding of allergen-driven asthma phenotypes and endotypes. In addition, ABT has been instrumental to assess the interactions and effects of new-targeted asthma treatments along these pathways.

摘要

目的综述

变应原支气管激发试验(ABT)已被用于研究哮喘的病理生理学,并作为一种疾病建模工具,评估新型哮喘药物的特性和疗效。鉴于哮喘的复杂性和异质性,这推动了几种表型和内型的定义,我们旨在讨论 ABT 在精准医学时代的作用,并为临床医生提供如何解释和使用现有数据的指导,以了解其对哮喘治疗获益的影响。

最近的发现

在这篇综述中,我们总结了 ABT 的背景知识和应用,并提供了该主题的最新出版物的更新。在过去的几年中,已经发表了几项关于 ABT 的研究,这些研究结合了非侵入性和侵入性气道采样以及创新的检测技术,使我们能够研究与 Th2 途径和变应原诱导的病理生理学相关的几个炎症机制,这些机制贯穿整个气道。

总结

ABT 是一种有价值的研究工具,它通过帮助确定变应原触发的关键炎症途径和气道病理生理学,为精准医学做出了重要贡献,从而有助于我们理解变应原驱动的哮喘表型和内型。此外,ABT 还用于评估沿着这些途径的新型靶向哮喘治疗的相互作用和效果。

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