Targeting TNF-alpha: a novel therapeutic approach for asthma.
Targeting TNF-alpha: a novel therapeutic approach for asthma.
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DOI：
10.1016/j.jaci.2007.10.028
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发表时间：
2008-01
期刊：
影响因子：
--
通讯作者：
Amrani Y
中科院分区：
文献类型：
--
作者：
Brightling C;Berry M;Amrani Y
大约5%-10%的哮喘患者患有严重疾病，对吸入性皮质类固醇治疗难治或反应不良。这些患者代表了一个重要的未满足的临床需求，因为他们经历了相当大的发病率和死亡率，并消耗了不成比例的大量卫生保健资源。TNF-α是一种促炎细胞因子，与哮喘气道病理学的许多方面有关。有证据表明，它可能在严重的难治性疾病中发挥重要作用。新型TNF-α拮抗剂的开发使我们能够测试这种细胞因子在体内的作用。初步研究表明，接受抗TNF-α治疗的患者的哮喘生活质量、肺功能和气道高反应性得到改善，加重频率降低。然而，有显着的异质性的反应，这表明受益可能是保留给一个小的亚组。重要的是，在报告疗效时，还需要在关注抗TNF-α治疗安全性的背景下考虑这一点。因此，临床医生面临的挑战是评估这些治疗在个体哮喘患者中的风险/获益比。
Approximately 5% to 10% of patients with asthma have severe disease that is refractory or poorly responsive to inhaled corticosteroid therapy. These patients represent an important unmet clinical need because they experience considerable morbidity and mortality and consume a disproportionately large amount of health care resources. TNF-α is a proinflammatory cytokine that has been implicated in many aspects of the airway pathology in asthma. Evidence is emerging to suggest that it might play an important role in severe refractory disease. The development of novel TNF-α antagonists has allowed us to test the role of this cytokine in vivo. Preliminary studies have demonstrated an improvement in asthma quality of life, lung function, and airway hyperresponsiveness and a reduction in exacerbation frequency in patients treated with anti–TNF-α therapy. However, there is marked heterogeneity in response, suggesting that benefit is likely to be reserved to a small subgroup. Importantly, where efficacy is reported, this also needs to be considered in the context of concerns about the safety of anti–TNF-α therapies. Therefore the challenge for clinicians is to evaluate the risk/benefit ratio of these therapies in individual patients with asthma.
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DOI：
10.1165/ajrcmb.10.5.8179909
发表时间：
1994-05-01
影响因子：
6.4
作者：
BRADDING, P;ROBERTS, JA;HOLGATE, ST
通讯作者：
HOLGATE, ST
影响因子：
24.3
作者：
Carroll, NG;Mutavdzic, S;James, AL
通讯作者：
James, AL
影响因子：
5.8
作者：
Franchimont, D;Martens, H;Geenen, V
通讯作者：
Geenen, V
影响因子：
4.8
作者：
Berger, P;Girodet, PO;de Lara, JMT
通讯作者：
de Lara, JMT
影响因子：
9.6
作者：
Brightling, CE
通讯作者：
Brightling, CE