Targeting airway inflammation in asthma - Current and future therapies
Targeting airway inflammation in asthma - Current and future therapies
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DOI：
10.1378/chest.07-0829
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发表时间：
2008-04-01
期刊：
影响因子：
9.6
通讯作者：
Hanania, Nicola A.
中科院分区：
文献类型：
--
作者：
Hanania, Nicola A.
哮喘是一种慢性呼吸道炎症性疾病，需要长期抗炎治疗。吸入型皮质类固醇(ICSS)被推荐作为持续性疾病的一线治疗药物，但并不是所有患者都能实现哮喘控制，即使在大剂量使用这些药物并与其他药物(包括长效β(2)激动剂或白三烯调节剂)联合使用时也是如此。这类患者可能需要额外的治疗。随着有关哮喘病理生理学和炎症表型的信息持续增加，以及其他抗炎选择的出现，有可能针对疾病的各个方面进行抗炎治疗，从而改善对标准ICS治疗反应不足的患者的治疗。几种新的抗炎疗法正处于不同的临床开发阶段。临床上最先进的是omalizumab，这是一种重组人源化单抗，专门针对IgE，适用于由过敏引起的中到重度哮喘患者。奥马珠单抗已经证明了对中到重度哮喘患者的疗效，并记录了过敏原敏感性的证据。临床开发中的其他关键治疗选择要么是针对促炎细胞因子(如白介素4和肿瘤坏死因子-α)，要么是针对炎症细胞(如辅助性T细胞2型细胞和嗜酸性粒细胞)。本文综述了目前和未来针对哮喘患者呼吸道炎症的治疗方法。
Asthma is a chronic inflammatory disease of the airway that requires long-term antiinflammatory therapy. Inhaled corticosteroids (ICSs) are recommended for first-line treatment of persistent disease, but not all patients achieve asthma control even when these agents are used in high doses and in combination with other medications, including a long-acting beta(2)-agonist or a leukotriene modifier. Such patients may require additional therapy. As information about asthma pathophysiology and inflammatory phenotypes continues to increase, and additional antiinflammatory options become available, it may be possible to target antiinflammatory therapy to various aspects of the disease and consequently to improve the treatment of patients with inadequate responses to standard ICS-based therapy. Several novel antiinflammatory therapies are in different stages of clinical development. The most clinically advanced of these is omalizumab, a recombinant humanized monoclonal antibody that specifically targets IgE and is indicated for patients with moderate-to-severe asthma caused by allergies. Omalizumab has demonstrated efficacy in patients with moderate-to-severe asthma and documented evidence of allergen sensitivity. Other key therapy options in clinical development either target proinflammatory cytokines (eg, interleukin-4 and tumor necrosis factor-alpha) or inflammatory cells (eg, T-helper type 2 cells and eosinophils). This review provides an overview of the current and future approaches targeting airway inflammation in patients with asthma.