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[特应性皮炎与支气管哮喘的现代诊断与治疗原则:临床病例]

[Principles of modern diagnosis and treatment of atopic dermatitis and bronchial asthma: Clinical case].

作者信息

Shogenova M S, Hutueva S H, Shogenova L S

机构信息

Allergology and Immunology Center.

Berbekov Kabardino-Balkarian State University.

出版信息

Ter Arkh. 2022 Mar 15;94(3):427-433. doi: 10.26442/00403660.2022.03.201430.

Abstract

This article presents the experience of successful use of the drug dupilumab in a patient with severe atopic dermatitis and bronchial asthma. The effectiveness of biological therapy with dupilumab 300 mg subcutaneously for 52 weeks of T-2 associated diseases, including a combination of severe atopic dermatitis and bronchial asthma, uncontrolled course based on the case history of patient Ts., born in 2006 with the diagnosis "Main: atopic dermatitis, common form, severe course. Concomitant diagnosis: bronchial asthma, persistent course, uncontrolled, moderate severity". Dynamic monitoring of the total blood count with the calculation of the absolute number of eosinophils in peripheral blood was performed. The study showed high efficacy and safety of biological therapy with dupilumab 300 mg subcutaneously every 2 weeks for 52 weeks with a combination of severe atopic dermatitis and bronchial asthma, uncontrolled course in patient Ts (Born in 2006). The examination of the ALEX2 allergochip made it possible to establish the molecular components of the primary causal allergens, predict the course of an allergic disease, and carry out successful elimination measures against food allergens, preserving the maximum set of nutrients in the patient's diet. Dupilumab therapy in severe atopic dermatitis and uncontrolled bronchial asthma leads to clinically significant improvement in the course of diseases, control of disease symptoms. Atopic dermatitis shows a decrease in itching of the skin, normalization of sleep, improvement of quality of life. With bronchial asthma, a reduction in exacerbations, normalization of respiratory function indicators, complete control of the disease has been achieved. The targeted biological drug dupilumab has a targeted effect on the key links in the pathogenesis of atopic dermatitis and bronchial asthma and reduces the burden of severe diseases. Therefore, the use of dupilumab in atopic dermatitis and bronchial asthma contributes to achieving disease control and improving the patient's quality of life.

摘要

本文介绍了在一名重度特应性皮炎和支气管哮喘患者中成功使用度普利尤单抗药物的经验。皮下注射300mg度普利尤单抗进行52周的生物治疗对T-2相关疾病有效,包括重度特应性皮炎和支气管哮喘的组合,根据患者Ts.的病史,其病程无法控制,患者Ts.出生于2006年,诊断为“主要诊断:特应性皮炎,常见型,重度病程。伴随诊断:支气管哮喘,持续性病程,无法控制,中度严重程度”。进行了全血细胞计数动态监测并计算外周血嗜酸性粒细胞绝对数。研究表明,对于患者Ts(出生于2006年)的重度特应性皮炎和支气管哮喘组合且病程无法控制的情况,每2周皮下注射300mg度普利尤单抗进行52周的生物治疗具有高疗效和安全性。对ALEX2过敏芯片的检测使得确定主要致病过敏原的分子成分、预测过敏性疾病的病程以及针对食物过敏原采取成功的消除措施成为可能,同时在患者饮食中保留最大量的营养成分。度普利尤单抗治疗重度特应性皮炎和无法控制的支气管哮喘可使疾病病程在临床上得到显著改善,控制疾病症状。特应性皮炎表现为皮肤瘙痒减轻、睡眠正常化、生活质量改善。对于支气管哮喘,发作次数减少、呼吸功能指标正常化,实现了疾病的完全控制。靶向生物药物度普利尤单抗对特应性皮炎和支气管哮喘发病机制的关键环节具有靶向作用,并减轻了重症负担。因此,在特应性皮炎和支气管哮喘中使用度普利尤单抗有助于实现疾病控制并改善患者生活质量。

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