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实现哮喘缓解的挑战与机遇

Challenges and Opportunities in Achieving Asthma Remission.

作者信息

Cojocaru Elena, Arcana Raluca Ioana, Radu Steluta, Trofor Antigona Carmen, Cojocaru Cristian

机构信息

Morpho-Functional Sciences II Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

Medical III Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.

出版信息

J Clin Med. 2025 Apr 20;14(8):2835. doi: 10.3390/jcm14082835.

Abstract

: Asthma is a chronic inflammatory disorder in millions of individuals across the globe with high morbidity, mortality, and health care costs. Despite advances in asthma treatment, long-term remission is a challenging target to achieve. This review will address the path to remission in asthma with focus on the role of biologic agents in severe asthma management and on the question as to whether long-term disease control and remission are a reality. : A systematic literature review from 1971 to 2025 was conducted through databases such as PubMed, MEDLINE, Scopus, and Web of Science. Clinical trials, meta-analyses, and real-world evidence concerning biologic therapies, such as monoclonal antibodies targeting interleukin -5 (IL-5), IL-4/IL-13, immunoglobulin E, and thymic stromal lymphopoietin, were considered. Symptom control, exacerbation frequency, lung function, and oral corticosteroid (OCS) use were some of the outcomes considered. : Biologic treatments have yielded significant gains in asthma control and reduction of exacerbation. Complete remission-long-term resolution of symptoms, inflammation, and drug dependence-is still difficult to achieve. Early intervention with biologics may prevent irreversible airway remodeling, but long-term remission is not in sight. These drugs reduce OCS dependency, but sustainability of remission remains to be investigated. : Biologic therapies have advanced asthma treatment, particularly in severe cases, by improving symptoms and reducing exacerbations. However, complete remission remains a distant goal. The development of standardized remission criteria, better patient stratification, and long-term clinical studies are necessary to help achieve sustained asthma control and remission.

摘要

哮喘是一种慢性炎症性疾病,全球数百万患者受其影响,发病率、死亡率高,医疗费用高昂。尽管哮喘治疗取得了进展,但实现长期缓解仍是一个具有挑战性的目标。本综述将探讨哮喘缓解之路,重点关注生物制剂在重度哮喘管理中的作用,以及长期疾病控制和缓解是否可行的问题。

通过PubMed、MEDLINE、Scopus和Web of Science等数据库,对1971年至2025年的文献进行了系统综述。纳入了关于生物疗法的临床试验、荟萃分析和真实世界证据,这些生物疗法包括靶向白细胞介素-5(IL-5)、IL-4/IL-13、免疫球蛋白E和胸腺基质淋巴细胞生成素的单克隆抗体。所考虑的结果包括症状控制、发作频率、肺功能和口服糖皮质激素(OCS)的使用情况。

生物治疗在哮喘控制和减少发作方面取得了显著进展。完全缓解——症状、炎症和药物依赖的长期消除——仍然难以实现。生物制剂的早期干预可能预防不可逆的气道重塑,但长期缓解仍遥遥无期。这些药物减少了对OCS的依赖,但缓解的可持续性仍有待研究。

生物疗法推动了哮喘治疗的进展,尤其是在重症病例中,改善了症状并减少了发作。然而,完全缓解仍然是一个遥远的目标。制定标准化的缓解标准、更好地对患者进行分层以及开展长期临床研究,对于实现哮喘的持续控制和缓解是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fc2/12027850/34b6582547aa/jcm-14-02835-g001.jpg

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