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2型炎症表型重度哮喘生物治疗的临床及病理组织学疗效——系统评价

The clinical and pathological histology efficacy of biological therapy for severe asthma with a phenotype of type 2 inflammation - systematic review.

作者信息

Ma Junhui, Ma Qiang, Yang Jing, Liang Panpan, Zhou Jiaxin, Ma Jiarui, Ma Fuhua, Zhuan Bing, Zhou Wei

机构信息

Department of Respiratory Medicine, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, Ningxia, China.

Department of Chest Surgery, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China.

出版信息

Front Immunol. 2025 Apr 15;16:1531986. doi: 10.3389/fimmu.2025.1531986. eCollection 2025.

DOI:10.3389/fimmu.2025.1531986
PMID:40303400
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12037598/
Abstract

Asthma is a complex, chronic inflammatory condition of the airways that comes in many forms. Because different inflammatory processes drive it, we can generally categorize asthma into two main types: type 2 inflammatory asthma and non-type 2 inflammatory asthma. Type 2 inflammation is usually the culprit in most folks grappling with severe asthma. There is a noticeable difference in the treatment approaches for different phenotypes of severe asthma. The main reason is that patients suffering from type 2 inflammatory asthma can respond well to treatment with biological agents. Several well-verified biological agents, such as anti-immunoglobulin E (IgE) monoclonal antibodies, anti-interleukin (IL)-4 monoclonal antibodies, anti-IL-5 monoclonal antibodies, and anti-thymic stromal lymphopoietin (TSLP) monoclonal antibodies, have shown outstanding effectiveness. They can significantly alleviate asthma exacerbations, lower the number of eosinophils, improve pulmonary function, decrease the dependence on oral corticosteroids, and elevate the quality of life for patients with asthma. This discourse meticulously evaluates the therapeutic prowess of biological agents in the treatment and control of severe asthma, concurrently investigating their impact on histological indices, to highlight the crucial role of precision medicine in the strategic concatenation of therapy for this refractory malady.

摘要

哮喘是一种复杂的慢性气道炎症性疾病,有多种形式。由于不同的炎症过程驱动着它,我们通常可以将哮喘分为两种主要类型:2型炎症性哮喘和非2型炎症性哮喘。2型炎症通常是大多数重度哮喘患者的病因。重度哮喘不同表型的治疗方法存在显著差异。主要原因是患有2型炎症性哮喘的患者对生物制剂治疗反应良好。几种经过充分验证的生物制剂,如抗免疫球蛋白E(IgE)单克隆抗体、抗白细胞介素(IL)-4单克隆抗体、抗IL-5单克隆抗体和抗胸腺基质淋巴细胞生成素(TSLP)单克隆抗体,已显示出卓越的疗效。它们可以显著减轻哮喘发作,降低嗜酸性粒细胞数量,改善肺功能,减少对口服糖皮质激素的依赖,并提高哮喘患者的生活质量。本文详细评估了生物制剂在重度哮喘治疗和控制中的治疗效果,同时研究它们对组织学指标的影响,以突出精准医学在这种难治性疾病治疗策略串联中的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/566ebceda5a0/fimmu-16-1531986-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/6d3891f4a31f/fimmu-16-1531986-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/c259e9ee8ab6/fimmu-16-1531986-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/566ebceda5a0/fimmu-16-1531986-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/6d3891f4a31f/fimmu-16-1531986-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/c259e9ee8ab6/fimmu-16-1531986-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/728f/12037598/566ebceda5a0/fimmu-16-1531986-g003.jpg

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本文引用的文献

1
Weighted Breaths: Exploring Biologic and Non-Biologic Therapies for Co-Existing Asthma and Obesity.加权呼吸:探索共存哮喘和肥胖的生物和非生物疗法。
Curr Allergy Asthma Rep. 2024 Jul;24(7):381-393. doi: 10.1007/s11882-024-01153-x. Epub 2024 Jun 15.
2
Precision medicine for severe asthma - Biological targeted therapy.精准医学治疗严重哮喘——生物靶向治疗。
Int Immunopharmacol. 2024 Jun 15;134:112189. doi: 10.1016/j.intimp.2024.112189. Epub 2024 May 16.
3
Association between pre-biologic T2-biomarker combinations and response to biologics in patients with severe asthma.
严重哮喘患者中 T2 生物标志物组合与生物制剂应答之间的关联。
Front Immunol. 2024 Apr 19;15:1361891. doi: 10.3389/fimmu.2024.1361891. eCollection 2024.
4
Exploring the immunopathology of type 2 inflammatory airway diseases.探索 2 型炎症性气道疾病的免疫病理学。
Front Immunol. 2024 Apr 12;15:1285598. doi: 10.3389/fimmu.2024.1285598. eCollection 2024.
5
Benralizumab in severe eosinophilic asthma by previous biologic use and key clinical subgroups: real-world XALOC-1 programme.贝那鲁肽在既往生物制剂治疗和关键临床亚组中的严重嗜酸性粒细胞性哮喘:真实世界 XALOC-1 项目。
Eur Respir J. 2024 Jul 11;64(1). doi: 10.1183/13993003.01521-2023. Print 2024 Jul.
6
Efficacy of dupilumab for airway hypersecretion and airway wall thickening in patients with moderate-to-severe asthma: A prospective, observational study.度普利尤单抗治疗中重度哮喘患者气道高分泌和气道壁增厚的疗效:一项前瞻性观察研究。
Allergol Int. 2024 Jul;73(3):406-415. doi: 10.1016/j.alit.2024.02.002. Epub 2024 Mar 12.
7
Omalizumab for the Treatment of Multiple Food Allergies.奥马珠单抗治疗多种食物过敏。
N Engl J Med. 2024 Mar 7;390(10):889-899. doi: 10.1056/NEJMoa2312382. Epub 2024 Feb 25.
8
Clinical characteristics of complete responders versus non-complete responders to omalizumab, benralizumab and mepolizumab in patients with severe asthma: a long-term retrospective analysis.奥马珠单抗、贝那利珠单抗和美泊利珠单抗治疗重度哮喘患者中完全应答者与非完全应答者的临床特征:一项长期回顾性分析。
Ann Med. 2024 Dec;56(1):2317356. doi: 10.1080/07853890.2024.2317356. Epub 2024 Feb 16.
9
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J Allergy Clin Immunol. 2024 Apr;153(4):988-997.e11. doi: 10.1016/j.jaci.2023.11.915. Epub 2023 Dec 9.
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Chest. 2024 Feb;165(2):253-266. doi: 10.1016/j.chest.2023.10.046. Epub 2023 Nov 3.