Severe Asthma: The Evolution of Patient-directed Management.
Severe Asthma: The Evolution of Patient-directed Management.
复制标题
严重哮喘：以患者为导向的管理的演变。
DOI：
10.1097/cpm.0000000000000013
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发表时间：
2014
影响因子：
--
通讯作者：
Kamp,David
中科院分区：
文献类型：
--
作者：
Keller,Michael;Kamp,David
重度哮喘已越来越被认为是一种具有不同临床特征和病理生理过程的异质性疾病。严重哮喘患者的日常生活受到严重损害，对卫生保健资源造成沉重负担。最近联合小组的工作改进了严重哮喘的定义，并更好地描述了患有严重疾病的患者。不同的方法，包括无偏聚类分析，已被用于确定由其临床特征和免疫过程定义的严重哮喘表型（亚组）。通过识别更有可能对特定药物产生反应的患者，对严重哮喘表型的识别有助于靶向治疗的发展。在本文中，我们讨论了我们对严重哮喘的理解的演变，并回顾了目前可用的治疗方法和正在开发的有希望的药物。此外，我们还研究了支气管镜检查在严重哮喘中的作用以及关于支气管热成形术的新证据。
Severe asthma has been increasingly recognized as a heterogenous disease with varied clinical characteristics and pathophysiological processes. Patients with severe asthma suffer significant impairment in their daily life and impose a substantial burden on health care resources. The recent work of consortia groups has led to an improved definition of severe asthma as well as better characterization of the patients with severe disease. Different approaches, including unbiased cluster analyses, have been utilized to identify severe asthma phenotypes (subgroups) defined by their clinical characteristics and immune processes. Recognition of severe asthma phenotypes has assisted the development of targeted therapies by identifying patients more likely to respond to the specific agent. In this article, we discuss the evolution of our understanding of severe asthma and review the currently available therapies and promising drugs in development. In addition, we examine the role of bronchoscopy in severe asthma and the emerging evidence regarding bronchial thermoplasty.