Anti-IgE therapy as novel target for asthma-COPD overlap syndrome: More questions before celebration
Anti-IgE therapy as novel target for asthma-COPD overlap syndrome: More questions before celebration
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抗 IgE 治疗作为哮喘-慢性阻塞性肺病重叠综合征的新靶点：庆祝之前还有更多问题
DOI：
10.1080/02770903.2016.1201838
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发表时间：
2017-02
影响因子：
1.9
通讯作者：
Shen Huahao
中科院分区：
文献类型：
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作者：
Xia Yang;Li Wen;Shen Huahao
我们饶有兴趣地阅读了 Tat 及其同事 [1] 的开创性工作。作者回顾了他们使用抗 IgE 单克隆抗体奥马珠单抗治疗哮喘-慢性阻塞性肺病重叠综合征 (ACOS) 患者的经验。奥马珠单抗治疗可减少哮喘发作、减少住院次数并提高哮喘控制测试（ACT）分数。然而，我们对研究设计和患者选择感到担忧。尽管恶化频率、住院率和ACT显着改善，但肺功能仍保持不变。如果通过纳入对照组来解释奥马珠单抗的安慰剂效应，这些数据将更有说服力。值得注意的是，最近的一项研究还发现奥马珠单抗可以减少 ACOS 患者的气道炎症并更好地控制症状[2]。这一发现与 Tat TS [1] 观察到的结果一致，尽管这两项研究的样本量都相当小，并且不是随机对照试验 (RCT) 设计。其次，参与本研究的三名患者均为重度吸烟者，胸部 CT 异常且 IgE 升高。因此，这些患者更有可能患有慢性阻塞性肺病。因此，我们仍然不知道奥马珠单抗是否能够改善 ACOS 的哮喘症状。因此，需要谨慎解释这项试点研究的结论，并需要进一步的临床试验来证实其结果。
We read the pioneer work by Tat and colleagues [1] with great interest. The authors reviewed their experience of treating asthma-COPD overlap syndrome (ACOS) patients with the anti-IgE monoclonal antibody, Omalizumab. Treatment with Omalizumab resulted in decreased asthma exacerbations, reduced hospitalizations and increased asthma control test (ACT) scores. However, we were concerned by the study design and patient selection. Although the exacerbation frequency, hospitalization and ACT were improved significantly, the lung function remained unchanged. These data would be more convincing if the placebo effects of Omalizumab were accounted for by including a control group. It is noteworthy that a recent study also found Omalizumab led to reduced airway inflammation and greater symptom control in ACOS patients [2]. This finding was consistent with the results observed by Tat TS [1], although both studies had rather small sample size and were not randomized controlled trial (RCT) design. Secondly, all three patients enrolled in the current study were heavy smokers with abnormal chest CT and elevated IgE. Therefore, these patients were more likely to suffer from the COPD component. Thus, we still do not know whether Omalizumab is functioning to improve in the asthma component of ACOS. As a result, the conclusion of this pilot study needs to be interpreted with caution and further clinical trials are required to confirm their results.
影响因子：
1.9
作者：
Tat, Tugba Songul;Cilli, Aykut
通讯作者：
Cilli, Aykut
影响因子：
3.3
作者：
Yalcin, Arzu Didem;Celik, Betul;Yalcin, Ata Nevzat
通讯作者：
Yalcin, Ata Nevzat