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喘患者的皮质类固醇耐药性背后的机制:对当前知识的综述
Javier Milara1,2,3, Anselm Morell1, Inés Roger1,3
1Department of Pharmacology, Faculty of Medicine, University of Valencia, Valencia, Spain.
Expert review of respiratory medicine
|September 1, 2023
概括
在喘中皮质类固醇不敏感会带来治疗挑战. 研究探讨了克服这种抗性的机制和策略,旨在为患有严重喘的患者提供更好的治疗选择.
科学领域:
- 肺病学和药理学 肺病学和药理学
- 炎症和免疫学 炎症和免疫学
背景情况:
- 皮质类固醇是主要的抗炎性喘治疗方法.
- 皮质类固醇不敏感会影响喘患者的一小部分,导致预后不佳.
- 鉴定皮质类固醇不敏感喘的替代疗法是一个重大的临床挑战.
研究的目的:
- 审查有关皮质类固醇反应的喘表型和内型.
- 阐明皮质类固醇作用和不敏感性的机制.
- 讨论扭转喘中皮质类固醇不敏感性的策略.
主要方法:
- 关于喘表型,内型和皮质类固醇机制的科学文献的综述.
- 分析导致皮质类固醇不敏感的分子机制,重点关注葡萄糖皮质类固醇受体 (GR) 途径.
- 检查药理学策略来克服皮质类固醇耐药性.
主要成果:
- 不同的皮质类固醇反应与特定的喘表型和内型有关.
- 皮质类固醇不敏感性通常与GR基因表达,结构和转录后修饰的改变有关.
- 从机械学见解中获得的有针对性的治疗策略显示出希望,但缺乏临床验证.
结论:
- 喘表型,内型和严重程度影响皮质类固醇不敏感,指导生物治疗选择.
- 了解皮质类固醇不敏感的分子机制对于开发向治疗至关重要.
- 临床试验对于将机械学发现转化为对皮质类固醇不敏感喘的有效疗法至关重要.
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