Lee Ye Jin, Park Yong-Bum
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Division of Pulmonary, Allergy & Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea.
Tuberc Respir Dis (Seoul). 2023 Jul;86(3):151-157. doi: 10.4046/trd.2022.0147. Epub 2023 Mar 23.
The introduction of inhaled corticosteroids (ICS) for the management of asthma has led to a decrease in acute exacerbation of asthma. However, there are concerns regarding the safety of long-term ICS use, particularly pneumonia. Growing evidence indicates that ICS use is associated with an increased risk of pneumonia in patients with chronic obstructive pulmonary disease, whereas the risk in patients with asthma remains unclear. This review discusses the effect of ICS on pneumonia among patients with asthma to update the existing literature. Asthma is associated with an increased risk of pneumonia. Several hypotheses have been proposed to explain this association, including that asthma impairs the clearance of bacteria owing to chronic inflammation. Therefore, controlling airway inflammation with ICS may prevent the occurrence of pneumonia in asthma. In addition, two meta-analyses investigating randomized control trials showed that ICS use was associated with a protective effect against pneumonia in asthma.
吸入性糖皮质激素(ICS)用于哮喘管理已使哮喘急性加重情况减少。然而,对于长期使用ICS的安全性存在担忧,尤其是肺炎方面。越来越多的证据表明,在慢性阻塞性肺疾病患者中使用ICS会增加肺炎风险,而哮喘患者使用ICS的风险仍不明确。本综述讨论ICS对哮喘患者肺炎的影响,以更新现有文献。哮喘与肺炎风险增加相关。已提出多种假说来解释这种关联,包括哮喘因慢性炎症而损害细菌清除功能。因此,使用ICS控制气道炎症可能预防哮喘患者发生肺炎。此外,两项对随机对照试验进行的荟萃分析表明,在哮喘患者中使用ICS对肺炎具有保护作用。