Asthma endotypes: A new approach to classification of disease entities within the asthma syndrome
Asthma endotypes: A new approach to classification of disease entities within the asthma syndrome
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DOI：
10.1016/j.jaci.2010.11.037
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发表时间：
2011-02-01
影响因子：
14.2
通讯作者：
Greenberger, Paul A.
中科院分区：
文献类型：
--
作者：
Lotvall, Jan;Akdis, Cezmi A.;Greenberger, Paul A.
越来越清楚的是，哮喘是一种复杂的疾病，由许多具有不同潜在病理生理的疾病变体组成。对这些疾病亚群机制的有限了解可能是理解哮喘病因和改善治疗的最大障碍，并且可以解释未能确定与哮喘一致的遗传和环境相关性。在这里，我们描述了一种假设，即哮喘综合征被分为具有特定机制的不同疾病实体，我们称之为“哮喘内型”。“内型”被认为是一种由不同病理生理机制定义的病症的亚型。根据其表型和假定的病理生理学，提出了确定哮喘内型的标准。使用这些标准，我们确定了几种拟议的哮喘内分型，并提出如何将这些新定义用于临床研究设计和药物开发，以针对最有可能受益的患者的现有和新疗法。这份PRACTALL（实用过敏）共识报告是由欧洲过敏和临床免疫学学会以及美国过敏、哮喘和免疫学学会的专家共同撰写的。[J] .中华变态反应杂志，2011;27:355-60。
It is increasingly clear that asthma is a complex disease made up of number of disease variants with different underlying pathophysiologies. Limited knowledge of the mechanisms of these disease subgroups is possibly the greatest obstacle in understanding the causes of asthma and improving treatment and can explain the failure to identify consistent genetic and environmental correlations to asthma. Here we describe a hypothesis whereby the asthma syndrome is divided into distinct disease entities with specific mechanisms, which we have called "asthma endotypes.'' An "endotype'' is proposed to be a subtype of a condition defined by a distinct pathophysiological mechanism. Criteria for defining asthma endotypes on the basis of their phenotypes and putative pathophysiology are suggested. Using these criteria, we identify several proposed asthma endotypes and propose how these new definitions can be used in clinical study design and drug development to target existing and novel therapies to patients most likely to benefit.This PRACTALL (PRACtical ALLergy) consensus report was produced by experts from the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology. (J Allergy Clin Immunol 2011;127:355-60.)