Advances in rhinitis and rhinosinusitis in 2015
Advances in rhinitis and rhinosinusitis in 2015
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DOI：
10.1016/j.jaci.2016.09.008
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发表时间：
2016-11-01
影响因子：
14.2
通讯作者：
Gevaert, Elien
中科院分区：
文献类型：
--
作者：
Bachert, Claus;Gevaert, Elien
过去的一年里，人们对上呼吸道疾病的认识和治疗取得了很大的进展。对于变应性鼻炎，作者关注的是对疾病自然病程的预测和影响。在随机或现实生活研究中，发表了关于过敏原免疫疗法在避免新的致敏和预防哮喘方面的疾病修饰作用的新证据。具体而言，对于常被低估且难以诊断的屋尘螨过敏患者，SQ屋尘螨舌下免疫治疗片的疗效已在过敏性鼻炎和哮喘患者中得到证实。过敏原免疫疗法首次显著降低了哮喘急性发作。在慢性鼻窦炎患者中，已经开发出一种纯粹基于T辅助细胞生物标志物的新型内分型方法，并通过与哮喘合并症和手术后复发的相关性显示出临床相关性。重度鼻息肉病伴哮喘合并症和疾病复发的风险高，其特征为2型炎症模式，包括葡萄球菌超抗原的IgE抗体;几项使用生物制剂的研究正好针对这类介质。这与来自上皮细胞的更多2型介质的新知识并行，这将扩大创新干预的可能候选者的数量。
The last year has seen great progress in the understanding of upper airway disease and in its management. For allergic rhinitis, authors focused on the prediction of and effect on the natural course of disease. New evidence was published for the disease-modifying effect of allergen immunotherapy in terms of avoidance of new sensitizations and prevention of asthma in either randomized or real-life studies. Specifically, for patients with house dust mite allergies, which are often underestimated and difficult to diagnose, the efficacy of SQ house dust mite sublingual immunotherapy tablets has been demonstrated in patients with allergic rhinitis and asthma. For the first time, allergen immunotherapy significantly reduced asthma exacerbations. In patients with chronic rhinosinusitis, a novel endotyping approach purely based on T helper cell biomarkers has been developed and has shown clinical relevance through associations with asthma comorbidity and recurrence after surgery. Severe nasal polyposis with high risk for asthma comorbidity and disease recurrence is characterized by type 2 inflammatory patterns, including IgE antibodies to staphylococcal superantigens; several studies using biologic agents have targeted exactly this spectrum of mediators. This goes in parallel with new knowledge on even more type 2 mediators derived from epithelial cells, which will expand the number of possible candidates for innovative intervention.