Research progress of dupilumab in the treatment of moderate to severe bronchial asthma
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摘要: 支气管哮喘是一种常见的慢性呼吸系统疾病，以慢性气道炎症和气道高反应性为其特征，临床常表现为反复发作的喘息、呼吸急促、胸闷、咳嗽等症状。中重度哮喘患者症状反复发作，如不能得到有效控制常导致肺功能下降。近年来生物靶向药物作为一种新的用于治疗重度哮喘的生物制剂，为哮喘患者提供了更多的治疗选择。目前可以在临床应用的主要有抗IgE单克隆抗体、抗IL-4受体单克隆抗体、抗IL-5受体单克隆抗体等。度普利尤单抗作为生物靶向治疗药物在治疗中重度支气管哮喘患者时疗效显著，其可以与IL-4Rα高亲和力结合，阻断IL-4和IL-13的信号传导，从而抑制2型气道炎症，改善肺部症状，控制哮喘发作。经度普利尤单抗治疗后的哮喘患者不仅生活质量得到提升，而且还可以减少糖皮质激素用量，减轻长期使用糖皮质激素给患者带来的一系列副作用。并且度普利尤单抗治疗哮喘安全性良好，严重不良反应较少，常见不良反应较轻且持续时间短，常可自行缓解。度普利尤单抗为哮喘患者的治疗提供新的策略，是国内外指南治疗重度哮喘患者的推荐药物。但目前国内上市时间较晚，研究报道较少，临床研究的周期短、样本量数据较少，仍需长期研究观察。本文将对度普利尤单抗治疗中重度支气管哮喘的临床治疗进展进行综述，为其进一步研究提供依据。Abstract: Bronchial asthma is a common chronic respiratory disease, which is characterized by chronic airway inflammation and airway hyperresponsiveness. The clinical manifestations are often recurrent wheezing, shortness of breath, chest tightness, cough, and other symptoms. Patients with moderate to severe asthma have recurrent symptoms, which often lead to decreased lung function if they cannot be effectively controlled. In recent years, as a new biological preparation for treating severe asthma, biologically targeted drugs have provided more treatment options for asthma patients. At present, the main clinical applications include anti IgE monoclonal antibodies, anti IL-4 receptor monoclonal antibodies, and anti IL-5 receptor monoclonal antibodies. Dupilumab, as a targeted biological drug, has a significant effect in the treatment of moderate to severe bronchial asthma. It can bind to IL-4Rα with high affinity and block the signal transduction of IL-4 and IL-13, thereby inhibiting type 2 airway inflammation, improving pulmonary symptoms, and controlling asthma attacks. Asthma patients treated with dupilumab not only improve their quality of life, but also reduce the dosage of glucocorticoids and alleviate a series of side effects caused by long-term use of glucocorticoids. Moreover, the safety of dupilumab in the treatment of asthma is good, with few serious adverse reactions. The common adverse reactions are mild and short-lived, and often can be relieved by themselves. Dupilumab provides a new strategy for the treatment of patients with asthma, and is the recommended drug for severe asthma in domestic and foreign guidelines. However, at present, the domestic market was launched relatively late, there are few research reports, the clinical research cycle is short, the sample size data is limited, and long-term research and observation are still needed. This article will review the clinical treatment progress of dupilumab in the treatment of moderate to severe bronchial asthma, providing a basis for further research.
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Key words:
- Bronchial asthma /
- IL-4Rα /
- Biologicals /
- Dupilumab
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表 1 其他治疗哮喘的生物制剂特征
Table 1. Characteristics of other biological agents for treating asthma
生物制剂 作用机制 适用标准 奥马珠单抗 抗IgE 重度过敏性哮喘伴血清总IgE水平增高 美泊利单抗 抗IL-5 外周血嗜酸性粒细胞≥300/μL的重度哮喘 贝那利单抗 抗IL-5R 外周血嗜酸性粒细胞≥150/μL的重度哮喘 
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