Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK.
Respiratory Medicine Unit and Oxford Respiratory NIHR BRC, Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK.
Immunol Allergy Clin North Am. 2024 Nov;44(4):709-723. doi: 10.1016/j.iac.2024.08.003. Epub 2024 Sep 2.
Our modern understanding of asthma mainly concerns identification of inflammatory endotype to guide management. The distinction mostly concerns identification of type-2 inflammation, for which different biomarkers have been well characterized. Blood eosinophils corroborate activity in the interleukin (IL)-5 axis while fraction of exhaled nitric oxide is indicative of the IL-4/IL-13 axis, giving us an indication of activity in these distinct but complementary pathways. These biomarkers predict disease activity, with increased risk of exacerbations when elevated, and a further, multiplicative increase when both are elevated. Serum immunoglobulin E is also implicated in this pathway, and can represent allergen-related stimulation.
我们对哮喘的现代理解主要涉及炎症表型的鉴定，以指导管理。这种区别主要涉及 2 型炎症的鉴定，为此已经很好地描述了不同的生物标志物。血液嗜酸性粒细胞证实了白细胞介素 (IL)-5 轴的活性，而呼气一氧化氮分数则表明了 IL-4/IL-13 轴的活性，这为我们提供了这些不同但互补途径活性的指示。这些生物标志物预测疾病的活动度，当升高时，加重的风险增加，当两者都升高时，风险进一步增加。血清免疫球蛋白 E 也与该途径有关，并且可以代表过敏原相关的刺激。
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