儿科重症监护病房的严重急性哮喘：我们能否将临床表型与免疫内型联系起来？
Severe acute asthma at the pediatric intensive care unit: can we link the clinical phenotypes to immunological endotypes?
机构信息
Department of Respiratory Medicine, Amsterdam Institute for Infection and Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Departmentof Pediatric Pulmonology, Amsterdam Public Health Institute, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
Expert Rev Respir Med. 2022 Jan;16(1):25-34. doi: 10.1080/17476348.2021.1997597. Epub 2021 Nov 18.
INTRODUCTION
The clinical phenotype of severe acute asthma at the pediatric intensive care unit (PICU) is highly heterogeneous. However, current treatment is still based on a 'one-size-fits-all approach'.
AREAS COVERED
We aim to give a comprehensive description of the clinical characteristics of pediatric patients with severe acute asthma admitted to the PICU and available immunological biomarkers, providing the first steps toward precision medicine for this patient population. A literature search was performed using PubMed for relevant studies on severe acute (pediatric) asthma.
EXPERT OPINION
Omics technologies should be used to investigate the relationship between cellular molecules and pathways, and their clinical phenotypes. Inflammatory phenotypes might guide bedside decisions regarding the use of corticosteroids, neutrophil modifiers and/or type of beta-agonist. A next step toward precision medicine should be inclusion of these patients in clinical trials on biologics.
介绍
儿科重症监护病房（PICU）中严重急性哮喘的临床表型高度异质。然而，目前的治疗仍然基于“一刀切”的方法。
涵盖领域
我们旨在全面描述收治到 PICU 的严重急性哮喘儿科患者的临床特征和现有的免疫生物学标志物，为该患者群体的精准医疗提供初步步骤。使用 PubMed 对严重急性（儿科）哮喘的相关研究进行了文献检索。
专家意见
应使用组学技术研究细胞分子和途径及其临床表型之间的关系。炎症表型可能有助于指导使用皮质类固醇、中性粒细胞调节剂和/或β-激动剂的床边决策。精准医疗的下一步应该是将这些患者纳入生物制剂的临床试验中。
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