失控的严重喘负担与没有升高的2型炎症生物标志物
Bo Ding1, Stephanie Chen2, Eleni Rapsomaniki3
1BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden.
The journal of allergy and clinical immunology. In practice
|December 23, 2023
概括
2型炎症生物标志物不能预测严重喘患者的疾病严重程度. 即使生物标志物水平较低,患者也会出现显著的症状和恶化,突出显示对有效治疗的未满足需求.
科学领域:
- 肺部病理学 肺部病理学
- 过敏和免疫学 过敏和免疫学
- 临床研究 临床研究
背景情况:
- 许多严重的喘病例涉及2型呼吸道炎症,由生物标志物如过敏史,血中异氨基细胞 (EOS) 的升高和高分数呼出的氧化 (FeNO) 表示.
- 了解这些生物标志物与疾病负担之间的关系对于有效的喘管理至关重要.
研究的目的:
- 评估与2型炎症生物标志物状态相关的未控制和控制的严重喘患者的疾病负担.
- 在NOVEL观测纵向研究 (NOVELTY) 中,评估了生物标志物分布及其与症状负担,健康状况,恶化和医疗利用的相关性.
主要方法:
- 记录了医生报告的喘诊断和严重程度.
- 控制喘是由喘控制测试得分 (不受控制的<20,控制的≥20) 和/或严重恶化.
- 分析了生物标志物状态 (过敏史,血液EOS,FeNO),症状得分,健康状况 (圣乔治呼吸道问卷),恶化和医疗资源使用.
主要成果:
- 在647名严重喘患者中,446人患有无法控制的喘. 其中,44%的人具有≥2个阳性生物标志物,42%的人具有1个,而73%的人具有低血EOS.
- 疾病负担在不受控制的喘亚组中始终很高,无论生物标志物状态如何.
- 患者报告症状控制不良,健康状况不佳,严重呼吸困难,频繁严重恶化 (70.6%-76.2%).
结论:
- 2型炎症生物标志物没有有效地区分严重喘患者的疾病负担.
- 有相当数量的2型生物标志物水平低的患者经历了相当大的疾病负担,这表明需要进一步的研究和治疗选择.
- 该研究强调,需要解决2型炎症生物标志物水平低的患者的治疗需求,因为目前的生物疗法可能不适合.
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