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基于慢性呼吸道疾病的炎症和粘膜功能障碍的内型
Erin Cant1, Mathieu Bottier1, Morven Shuttleworth1
1Division of Respiratory Medicine and Gastroenterology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
Chest
|August 28, 2025
概括
慢性呼吸道疾病如慢性肺炎和喘具有共同的炎症和粘膜功能障碍. 患者可以根据生物炎症内型进行分类,而不仅仅是疾病标签,
科学领域:
- 肺部医学
- 免疫学
- 微生物学
背景情况:
- 慢性呼吸道疾病,如COPD,喘,支气管炎 (BE) 和囊性纤维化 (CF),具有重叠的临床特征.
- 主要特征包括呼吸道炎症和粘膜清除受损.
研究的目的:
- 研究慢性呼吸道疾病中的炎症和粘膜清除之间的关系.
- 确定生物因素,而不是传统的疾病标签,可以将患者分为治疗相关的亚型.
主要方法:
- 对患有喘,COPD,BE和CF的患者进行了分类,并对自发进行了分析.
- 测量包括炎症标志物 (中性细胞弹性酶,细胞因子),唾液特性 (DNA,粘膜,质,干重) 和微生物组合.
- 基于生物特征的患者亚型被采用K- 平均分类.
主要成果:
- 在疾病组和对照组之间观察到炎症标志物,唾液特性和微生物群多样性的显著差异.
- 通过K-means聚类,确定了两种不同的炎症内型:中性和Th2-主导.
- 中性友爱的内型与更严重的疾病特征有关,肠微生物群中的蛋白质菌增加,并且在CF和BE患者中更为普遍.
- Th2内型表现出明显的唾液特性和微生物组特征.
结论:
- 具有异质粘液特性和炎症特征的呼吸道疾病.
- 基于炎症内型而不是仅仅基于疾病标签的患者分层是可行的和临床相关的.
- 将内型鉴定与炎症和粘膜清除生物标志物相结合,可以改善患者的评估,并指导治疗决策.
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