Brightling Christopher E, Marone Gianni, Aegerter Helena, Chanez Pascal, Heffler Enrico, Pavord Ian D, Rabe Klaus F, Uller Lena, Dorscheid Del
Institute for Lung Health, National Institute for Health and Care Research Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
Joint first authors.
Eur Respir Rev. 2024 Dec 18;33(174). doi: 10.1183/16000617.0221-2024. Print 2024 Oct.
The Epithelial Science Expert Group convened on 18-19 October 2023, in Naples, Italy, to discuss the current understanding of the fundamental role of the airway epithelium in asthma and other respiratory diseases and to explore the future direction of patient care. This review summarises the key concepts and research questions that were raised. As an introduction to the epithelial era of research, the evolution of asthma management throughout the ages was discussed and the role of the epithelium as an immune-functioning organ was elucidated. The role of the bronchial epithelial cells in lower airway diseases beyond severe asthma was considered, as well as the role of the epithelium in upper airway diseases such as chronic rhinosinusitis. The biology and application of biomarkers in patient care was also discussed. The Epithelial Science Expert Group also explored future research needs by identifying the current knowledge and research gaps in asthma management and ranking them by priority. It was identified that there is a need to define and support early assessment of asthma to characterise patients at high risk of severe asthma. Furthermore, a better understanding of asthma progression is required. The development of new treatments and diagnostic tests as well as the identification of new biomarkers will also be required to address the current unmet needs. Finally, an increased understanding of epithelial dysfunction will determine if we can alter disease progression and achieve clinical remission.
上皮科学专家组于2023年10月18日至19日在意大利那不勒斯召开会议，讨论目前对气道上皮在哮喘和其他呼吸系统疾病中的基本作用的认识，并探索患者护理的未来方向。本综述总结了会上提出的关键概念和研究问题。作为上皮研究时代的引言，讨论了哮喘管理的历史演变，并阐明了上皮作为免疫功能器官的作用。探讨了支气管上皮细胞在除重度哮喘之外的下呼吸道疾病中的作用，以及上皮在慢性鼻窦炎等上呼吸道疾病中的作用。还讨论了生物标志物在患者护理中的生物学特性及应用。上皮科学专家组还通过确定哮喘管理方面的现有知识和研究差距并按优先级进行排序，探索了未来的研究需求。会议确定，有必要界定并支持哮喘的早期评估，以确定重度哮喘高危患者的特征。此外，还需要更好地了解哮喘的进展情况。为满足当前未得到满足的需求，还需要开发新的治疗方法和诊断测试，并识别新的生物标志物。最后，对上皮功能障碍的深入了解将决定我们是否能够改变疾病进展并实现临床缓解。
