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[精准医学在哮喘诊断与治疗中的应用]

[Precision medicine in the diagnosis and treatment of asthma].

作者信息

Lommatzsch Marek

机构信息

Abteilung für Pneumologie, Zentrum für Innere Medizin, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.

出版信息

Inn Med (Heidelb). 2024 Mar;65(3):229-238. doi: 10.1007/s00108-024-01666-7. Epub 2024 Feb 15.

Abstract

Due to the availability of disease-modifying anti-asthmatic drugs (DMAADs), especially inhaled steroids (alone or in combination with long-acting bronchodilators), biologics and modern allergen immunotherapy, the treatment of asthma has fundamentally changed. The aims of modern asthma precision medicine are prevention of symptoms and the induction and maintenance of asthma remission (long-term asthma control, freedom from exacerbations and stable lung function without the use of systemic steroids). A treat to target approach is used as for other chronic inflammatory diseases in internal medicine: the aim is to achieve remission by an individually tailored treatment with DMAADs; however, the prerequisite for modern asthma precision medicine is asthma phenotyping, including a detailed medical history, lung function testing, allergological diagnostics and measurement of type 2 markers (blood eosinophils and, if available, exhaled nitric oxide, FeNO).

摘要

由于可获得疾病修正抗哮喘药物(DMAADs),尤其是吸入性类固醇(单独使用或与长效支气管扩张剂联合使用)、生物制剂和现代变应原免疫疗法,哮喘的治疗已发生了根本性变化。现代哮喘精准医学的目标是预防症状以及诱导和维持哮喘缓解(长期哮喘控制、无急性加重且在不使用全身类固醇的情况下肺功能稳定)。与内科其他慢性炎症性疾病一样,采用了靶向治疗方法:目标是通过使用DMAADs进行个体化定制治疗来实现缓解;然而,现代哮喘精准医学的前提是哮喘表型分析,包括详细的病史、肺功能测试、变应性诊断以及2型标志物(血液嗜酸性粒细胞,若可行,还有呼出一氧化氮,FeNO)的测量。

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