在喘治疗中准interleukin途径
1Experimental Studies, Airway Disease Section, National Heart and Lung Institute, Imperial College London, London, UK; National Institute for Health Research (NIHR), Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College London, London, UK.
Lancet (London, England)
|September 19, 2015
概括
阻断T-助手-2 (Th2) 细胞因子的向治疗对严重的酸性喘具有前景. 生物标志物对于识别将受益于这些先进治疗的患者至关重要.
科学领域:
- 免疫学
- 肺病学
- 药理学
背景情况:
- 喘是一种复杂的呼吸系统疾病,尽管接受了标准治疗,但仍有一部分患者出现严重症状.
- 严重喘的特点是控制不良,频繁恶化,持续阻塞空气流.
- 在近一半的严重喘病例中,来自T-助手-2 (Th2) 细胞的白血素 (IL-4,IL-5,IL-13) 参与了酸性和过敏性炎症.
研究的目的:
- 审查Th2驱动炎症在严重喘中的作用.
- 评估针对性生物治疗的疗效,包括抗IgE和抗细胞因子单克隆抗体,用于严重的喘.
- 讨论生物标志物的潜力,以指导严重喘的治疗决策.
主要方法:
- 对严重喘病理生理学和治疗的现有文献的审查.
- 对针对性治疗研究的分析,如奥马利祖马布,抗IL-5,抗IL-4Rα和抗IL-13抗体.
- 检查临床结果,包括恶化,喘控制和肺功能 (FEV1).
主要成果:
- 抗IgE治疗 (奥马利祖马布) 对严重的过敏性喘有效.
- 针对IL- 5,IL- 4Rα或IL- 13的单克隆抗体已在严重酸性喘患者中显示出改善的结果.
- 美国食品和药物管理局 (FDA) 已推抗IL-5抗体用于严重的酸性喘,这表明抗Th2药物具有治疗作用.
结论:
- 针对性的抗Th2生物疗法在治疗严重酸性喘方面取得了重大进展.
- 鉴定生物标志物对于选择适合这些选择性抗体治疗的患者至关重要.
- 目前的治疗方法不能治疗由低Th2表达的非酸性炎症引起的喘.
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