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哮喘管理的最新进展概述。

Overview of recent advancements in asthma management.

机构信息

Department of Respiratory Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Intern Med J. 2022 Sep;52(9):1478-1487. doi: 10.1111/imj.15904.

Abstract

Asthma is a common but complex heterogenous inflammatory airway disorder. Despite significant developments in our understanding of the pathophysiology and treatment of asthma, it remains a major cause of mortality and morbidity. Optimal management involves addressing modifiable risk factors, titration of inhaled pharmacotherapy in a stepwise approach and, in severe disease, consideration of biologic agents. Appreciation of the clinical characteristics of asthma and recognition of the immune pathways involved has allowed the development of phenotypic and endotypic subtypes of asthma to be better defined. This has revolutionised asthma management, allowing risk stratification of patients, targeted use of biologic agents to modify cytokine responses that drive asthma and improved patient outcomes. Patient education and engagement are critical to the management of this disease in an era of personalised medicine and a rapidly changing global environment.

摘要

哮喘是一种常见但复杂的异质性炎症性气道疾病。尽管我们对哮喘的病理生理学和治疗有了显著的了解,但它仍然是导致死亡率和发病率的主要原因。最佳管理包括解决可改变的危险因素、逐步滴定吸入性药物治疗以及在严重疾病中考虑生物制剂。对哮喘临床特征的认识和对涉及的免疫途径的认识,使得哮喘的表型和内型亚型能够更好地定义。这彻底改变了哮喘的管理方式,允许对患者进行风险分层,靶向使用生物制剂来改变驱动哮喘的细胞因子反应,并改善患者的预后。在个体化医学和快速变化的全球环境时代,患者教育和参与对于这种疾病的管理至关重要。

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