Anaev E K
Pirogov Russian National Research Medical University.
Ter Arkh. 2023 Oct 11;95(8):696-700. doi: 10.26442/00403660.2023.08.202316.
Over the past decades, chronic obstructive pulmonary disease (COPD) has become a major public health problem due to increasing morbidity and mortality. COPD is characterized by airflow limitation due to inflammation of the bronchial tree and remodeling of the small airways. In 20-40% of patients with COPD, eosinophilic inflammation of the airways is observed, as in bronchial asthma. Eosinophilic COPD has recently been shown to be a distinct disease and is associated with more pronounced airway remodeling. Although the role of eosinophils in the pathogenesis of COPD is not fully understood, the level of eosinophils can be used in the prognosis and administration of corticosteroids, and their effectiveness is higher in eosinophilia. Currently, monoclonal antibodies directed against interleukins (IL-5, IL-4 and IL-13) or their receptors are being tested in the T2 endotype of COPD. This review focuses on the mechanisms of eosinophilia in COPD, the use of blood and sputum eosinophils as a biomarker, and the advisability of using monoclonal antibodies in the treatment of eosinophilic COPD.
在过去几十年中，由于发病率和死亡率不断上升，慢性阻塞性肺疾病（COPD）已成为一个主要的公共卫生问题。COPD的特征是由于支气管树炎症和小气道重塑导致气流受限。在20%至40%的COPD患者中，观察到气道嗜酸性粒细胞炎症，与支气管哮喘情况相同。最近研究表明，嗜酸性粒细胞性COPD是一种独特的疾病，且与更明显的气道重塑有关。尽管嗜酸性粒细胞在COPD发病机制中的作用尚未完全明确，但嗜酸性粒细胞水平可用于COPD的预后评估和皮质类固醇的使用，且在嗜酸性粒细胞增多的情况下其疗效更高。目前，针对白细胞介素（IL-5、IL-4和IL-13）或其受体的单克隆抗体正在COPD的T2内型中进行试验。本综述重点关注COPD中嗜酸性粒细胞增多的机制、血液和痰液嗜酸性粒细胞作为生物标志物的应用，以及使用单克隆抗体治疗嗜酸性粒细胞性COPD的合理性。
