严重哮喘和omalizumab的选择。
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米勒CW，克里斯那斯瓦米N，约翰斯顿C，克里斯那斯瓦米G
严重哮喘和omalizumab的选择。
2008年5月20日;6:4。doi: 10.1186 / 1476-7961-6-4。
- PubMed ID
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18489791 (PubMed视图］
- 摘要
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特应性疾病和哮喘在全球范围内正以惊人的速度增长。现在公认哮喘是一种呼吸道慢性炎症性疾病。许多患者的炎症过程是由免疫球蛋白E (IgE)依赖过程驱动的。针对过敏原和IgE，肥大细胞激活和介质释放导致级联反应，最终导致B淋巴细胞、T淋巴细胞、嗜酸性粒细胞、成纤维细胞、平滑肌细胞和内皮细胞激活。这种复杂的细胞相互作用、细胞因子、趋化因子和生长因子的释放以及气道的炎症重塑导致慢性哮喘。一部分病人会出现严重的气道疾病，这种疾病可能非常病态，甚至致命。虽然有许多治疗哮喘的方法，但它仍然是一种慢性和不治之症，其特点是病情加重、住院治疗和药物的相关不良反应。Omalizumab是一种治疗慢性哮喘的新选择，它通过结合和抑制IgE的作用起作用，从而干扰前面提到的哮喘级联的一个方面。这是一种针对IgE的人源单克隆抗体，已被证明对哮喘有许多有益的影响。omalizumab的使用可能受到药物成本和一些报告的不良反应的影响，包括罕见的过敏反应的可能性。 When used in selected cases and carefully, omalizumab provides a very important tool in disease management. It has been shown to have additional effects in urticaria, angioedema, latex allergy and food allergy, but the data is limited and the indications far from clear. In addition to decreasing exacerbations, it has a steroid sparing role and hence may decrease adverse effects in some patients on high-dose glucocorticoids. Studies have shown improvement in quality of life measures in asthma following the administration of omalizumab, but the effects on pulmonary function are surprisingly small, suggesting a disconnect between pulmonary function, exacerbations and quality of life. Anaphylaxis may occur rarely with this agent and appropriate precautions have been recommended by the Food and Drug Administration (FDA). As currently practiced and as suggested by the new asthma guidelines, this biological agent is indicated in moderate or severe persistent allergic asthma (steps 5 and 6).
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