2型糖尿病在成人哮喘严重程度中的作用。
The role of type 2 diabetes in the severity of adult asthma.
作者信息
Pham Alisa, Corcoran Rose, Foer Dinah
机构信息
Division of Allergy and Clinical Immunology, Department of Medicine, Brigham and Women's Hospital.
Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Curr Opin Allergy Clin Immunol. 2025 Feb 1;25(1):34-40. doi: 10.1097/ACI.0000000000001045. Epub 2024 Nov 20.
PURPOSE OF REVIEW
This review summarizes recent basic, translational, and clinical research on type 2 diabetes (T2D) and its relationship with asthma severity in the context of T2D mechanisms and asthma outcomes.
RECENT FINDINGS
Several clinical asthma outcomes, such as lung function and exacerbations, demonstrate a strong association between T2D and asthma and support that T2D contributes to worse asthma outcomes. Multiple mechanisms underlying those observed associations, and their representative biomarkers, have been proposed. However, prospective, controlled human studies in the context of both T2D and asthma are limited.
SUMMARY
T2D is associated with worse asthma outcomes and more severe asthma. Yet patients with more severe or uncontrolled asthma are also at a higher risk for systemic steroid exposure, which worsens glycemic control and metabolic dysregulation. Preclinical and translational studies point to metabolic dysregulation as a driver of airway inflammation. Addressing these metabolic pathways through T2D treatment may, in turn, directly or indirectly improve clinical asthma outcomes. While additional research is needed to identify biomarkers of risk and treatment response in metabolic asthma, this review highlights the importance of considering T2D as a clinically relevant asthma comorbidity.
综述目的
本综述总结了近期关于2型糖尿病(T2D)及其在T2D机制和哮喘结局背景下与哮喘严重程度关系的基础、转化和临床研究。
最新发现
一些临床哮喘结局,如肺功能和急性加重,表明T2D与哮喘之间存在密切关联,并支持T2D会导致更差的哮喘结局。已提出了这些观察到的关联背后的多种机制及其代表性生物标志物。然而,在T2D和哮喘背景下的前瞻性对照人体研究有限。
总结
T2D与更差的哮喘结局和更严重的哮喘相关。然而,哮喘更严重或未得到控制的患者全身使用类固醇的风险也更高,这会使血糖控制和代谢失调恶化。临床前和转化研究指出代谢失调是气道炎症的驱动因素。通过T2D治疗解决这些代谢途径可能反过来直接或间接改善临床哮喘结局。虽然需要更多研究来确定代谢性哮喘的风险和治疗反应生物标志物,但本综述强调了将T2D视为临床上相关的哮喘合并症的重要性。
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