非嗜酸性粒细胞哮喘诊治进展

Research progress in the diagnosis and treatment of non-eosinophilic asthma

摘要:

哮喘是全球最常见的慢性呼吸系统疾病之一，非嗜酸性粒细胞哮喘（non-eosinophilic asthma，NEA）是哮喘的一种特殊表型，其气道炎症的特征是细胞浸润以中性粒细胞为主，缺乏嗜酸性粒细胞。NEA发病与环境及宿主因素均有关，例如职业暴露、环境污染、吸烟、感染和肥胖，上述风险因素单独或联合作用可以激活特定的细胞和分子途径，导致NEA发生。NEA的临床特征是对标准哮喘治疗的反应不佳，尤其是对吸入性皮质类固醇，导致疾病更严重和难以控制的哮喘。虽然NEA不是最普遍的哮喘表型，但重度哮喘患者中NEA比例高，其重要性不容忽视。本文就近年来NEA的流行病学现状、致病因素、发病机制和治疗现状作一综述。

Abstract:

Asthma is one of the most common chronic respiratory diseases in the world. Non-eosinophilic asthma（NEA） is a special type of asthma. NEA is characterized by airway inflammation with the absence of eosinophils， and the cellular infiltration is dominated by neutrophils. NEA is associated with environmental and host factors，such as occupational exposure，environmental pollution，smoking，infection，and obesity，which can，alone or in combination，activate specific cellular and molecular pathways to result in NEA. NEA features a poor response to standard asthma treatments，especially inhaled corticosteroids，which can lead to more serious and unmanageable asthma. Although NEA is not the most common type of asthma，it cannot be ignored because of a high proportion in patients with severe asthma. This article reviews the epidemiology，pathogenic factors，pathogenesis，and treatment of NEA in recent years.