Biomarkers in the Management of Difficult Asthma

被引：46

作者：

Schleich, Florence ^{[1
]}

Sophie, Demarche ^{[1
]}

Renaud, Louis ^{[1
]}

机构：

[1] CHU Sart Tilman B35, Resp Med, GIGA I3, B-4000 Liege, Belgium

来源：

CURRENT TOPICS IN MEDICINAL CHEMISTRY | 2016年 / 16卷 / 14期

关键词：

Airway remodeling; Biomarker; Difficult asthma; Inflammation; Phenotype; Severe; LUNG-FUNCTION DECLINE; EXHALED NITRIC-OXIDE; NECROSIS-FACTOR-ALPHA; NEUTROPHILIC AIRWAY INFLAMMATION; OBSTRUCTIVE PULMONARY-DISEASE; PREDNISONE-DEPENDENT ASTHMA; SPUTUM EOSINOPHILS PREDICT; DOUBLE-BLIND; PERSISTENT ASTHMA; BRONCHIAL THERMOPLASTY;

D O I：

10.2174/1568026616666151015093406

中图分类号：

R914 [药物化学];

学科分类号：

100701 ;

摘要：

Difficult asthma is a heterogeneous disease of the airways including various types of bronchial inflammation and various degrees of airway remodeling. Therapeutic response of severe asthmatics can be predicted by the use of biomarkers of Type2-high or Type2-low inflammation. Based on sputum cell analysis, four inflammatory phenotypes have been described. As induced sputum is time-consuming and expensive technique, surrogate biomarkers are useful in clinical practice. Eosinophilic phenotype is likely to reflect ongoing adaptive immunity in response to allergen. Several biomarkers of eosinophilic asthma are easily available in clinical practice (blood eosinophils, serum IgE, exhaled nitric oxyde, serum periostin). Neutrophilic asthma is thought to reflect innate immune system activation in response to pollutants or infectious agents while paucigranulocytic asthma is thought to be not inflammatory and characterized by smooth muscle dysfunction. We currently lack of user-friendly biomarkers of neutrophilic asthma and airway remodeling. In this review, we summarize the biomarkers available for the management of difficult asthma.

引用

页码：1561 / 1573

页数：13

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