Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.
Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Tennessee Valley Healthcare System, United States Department of Veterans Affairs, Nashville, TN, USA.
Curr Opin Immunol. 2020 Oct;66:161-166. doi: 10.1016/j.coi.2020.10.006. Epub 2020 Nov 22.
Overlap of asthma and chronic obstructive lung disease (ACO) in patients with obstructive lung disease is growing in recognition, though there is no consistent agreement on the diagnostic criteria for the disease process. Patients with ACO have distinct clinical characteristics and trajectories, which are representative of a heterogenous, multifactorial, and incompletely understood inflammatory pathophysiology. Current treatment strategies are focused on titration of inhaled therapies such as long-acting bronchodilators, with increasing interest in the use of targeted biologic therapies aimed at the underlying inflammatory mechanisms. Future directions for research will focus on elucidating the varied inflammatory signatures leading to ACO, the development of consistent diagnostic criteria and biomarkers of disease, and improving the clinical management with an eye toward targeted therapies.
哮喘和慢性阻塞性肺疾病(ACO)在阻塞性肺疾病患者中的重叠现象日益受到关注,尽管对于疾病过程的诊断标准尚无一致共识。ACO 患者具有独特的临床特征和轨迹,代表了一种异质的、多因素的、尚未完全理解的炎症病理生理学。目前的治疗策略侧重于吸入疗法(如长效支气管扩张剂)的滴定,越来越关注针对潜在炎症机制的靶向生物疗法的使用。未来的研究方向将集中在阐明导致 ACO 的不同炎症特征、制定一致的诊断标准和疾病生物标志物,以及改善着眼于靶向治疗的临床管理。