慢性鼻炎与鼻的生物学:韩国的现状和临床考虑
Ki-Il Lee1, Gwanghui Ryu2, Shin Hyuk Yoo3
1Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea.
概括
生物学家为患有鼻息肉的慢性鼻炎 (CRSwNP) 提供了新的希望,更新了指导方针,改进了指示和应对措施. 研究探讨了CRSwNP生物治疗的成本有效策略,包括调整剂量.
科学领域:
- 免疫学 免疫学 免疫学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 药理学 药理学是指药理学的学科.
背景情况:
- 带鼻息肉的慢性鼻炎 (CRSwNP) 显著影响患者的生活质量和医疗保健资源.
- 针对2型免疫路径的生物药物代表了严重或不受控制的CRSwNP的先进治疗选择.
- 之前的指导方针 (EPOS 2020,EUFOREA) 提供了CRSwNP生物使用的初步指导,但关于指示和结果的数据有限.
研究的目的:
- 总结CRSwNP中生物治疗指南的演变,重点关注EPOS/EUFOREA 2023年更新.
- 要突出精细的临床指示,响应评估和生物药物治疗策略在CRSwNP.
- 讨论实际考虑,包括在特定医疗保健系统中的成本效益和调整剂量以及新兴的生物制剂.
主要方法:
- 最近的研究和指导方针更新 (EPOS/EUFOREA 2023) 关于CRSwNP的生物治疗方法的审查和综合.
- 分析血液中乙氨基酸值的变化,以确定2型炎症.
- 评估新的反应标准和推的治疗评估时间表.
主要成果:
- 在EPOS/EUFOREA 2023更新中,在CRSwNP中降低了血中乙氨基的临界值为150细胞/μL,用于CRSwNP中的生物指示.
- 对生物制剂的反应现在根据多体大小,生活质量和气味的改善被分为三个级别.
- 建议在6个月后对治疗进行评估,每年进行随访,更长的剂量间隔 (例如每四周一次) 对得到良好控制的患者是有效的.
结论:
- 更新的指南为CRSwNP中的生物制剂提供了更明确的指示和应对措施.
- 临床判断对于管理治疗持续时间,停药或转换生物药物至关重要.
- 需要进一步的研究来优化生物策略,特别是关于成本效益和适应多样化的医疗保健系统,新型药物如tezepelumab显示承诺.
相关概念视频
01:17Drugs Used in Lower Respiratory Disorders: Overview
284
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
284
01:16Drugs Used in Upper Respiratory Disorders: Overview
151
Upper respiratory tract disorders, including viral infections and allergic rhinitis, cause significant discomfort and disrupt daily life. Managing these conditions involves a variety of drugs, such as antihistamines, intranasal steroids, decongestants, antitussives, expectorants, and mucolytics. Specific examples of drugs in each category are provided.
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
151
01:30Epistaxis
113
Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
113
01:25Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids
160
Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
160
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
103
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
103
01:23Chronic Pharyngitis
705
Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
705