Clinical phenotypes of chronic obstructive pulmonary disease and asthma: Recent advances
Clinical phenotypes of chronic obstructive pulmonary disease and asthma: Recent advances
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DOI：
10.1016/j.jaci.2013.01.010
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发表时间：
2013-03-01
影响因子：
14.2
通讯作者：
Sutherland, E. Rand
中科院分区：
文献类型：
--
作者：
Carolan, Brendan J.;Sutherland, E. Rand
哮喘和慢性阻塞性肺疾病(COPD)是常见的阻塞性肺疾病，均以气流受限为特征。虽然两者代表不同的致病实体，但这两种疾病之间可能存在显著的临床和生理重叠，给临床医生带来潜在的管理困难。尽管针对这两种疾病的实践指南概述了诊断和处理策略，但哮喘和COPD是高度不同的，尽管遵守了当前的指南，但许多患者的症状仍然控制不佳。表型研究的最新进展阐明了这些呼吸道疾病的异质性，可能是提高哮喘和COPD患者的诊断、预测结果和个性化治疗的最佳机会。这篇综述将集中于描述哮喘和COPD表型异质性的最新进展，包括对多个临床变量、分子生物标记物、生理学和放射学数据的评估，以及与疾病进展和频繁加重相关的因素。(《过敏与免疫杂志》2013；131：627-34。)
Asthma and chronic obstructive pulmonary disease (COPD) are prevalent obstructive lung diseases, both of which are characterized by airflow limitation. Although both represent distinct pathogenic entities, there can be significant clinical and physiologic overlap between the 2 disorders, creating potential management difficulties for clinicians. Although practice guidelines for both conditions outline diagnostic and management strategies, asthma and COPD are highly heterogeneous, and the symptoms of many patients remain poorly controlled despite adherence to current guidelines. Recent advances in phenotyping studies have elucidated heterogeneity in these airway diseases and might represent the best opportunity to enhance diagnosis, predict outcomes, and personalize treatments in patients with asthma and those with COPD. This review will focus on recent advances in describing phenotypic heterogeneity in asthma and COPD, including the evaluation of multiple clinical variables, molecular biomarkers, physiologic and radiologic data, and factors associated with disease progression and frequent exacerbations. (J Allergy Clin Immunol 2013;131:627-34.)