嗜酸性粒细胞型慢性阻塞性肺疾病发病机制及个体化治疗的研究进展

Research progress on pathogenesis and individualized treatment in patients with eosinophilic chronic obstructive pulmonary disease

近年来,嗜酸性粒细胞(EOS)在慢性阻塞性肺疾病(COPD)治疗中备受关注。部分COPD患者的气道炎症反应和全身炎症反应较为活跃,循环血EOS升高,并涉及多种炎性标志物。目前,EOS阈值与COPD患者临床治疗的相关性仍存在争议,但EOS计数已作为生物标志物应用于临床,特别是在COPD患者吸入糖皮质激素后,在改善预后以及防止病情恶化方面获益匪浅。此外,针对嗜酸性炎症的多种治疗方法已经或正在研究开发中,包括针对白细胞介素、趋化因子等炎症介质及其受体的单克隆抗体等。本文对EOS的生物学特征、在COPD发病机制中的作用以及作为生物标志物在个体化治疗决策方面的价值综述如下。

In recent years,eosinophil(EOS)has attracted much attention in the treatment of chronic obstructive pulmonary disease(COPD).Some COPD patients are observed with active airway inflammation and systemic inflammation,increase of circulating EOS,and a variety of involved inflammatory markers.At present,the relationship between EOS threshold and clinical treatment of COPD is still controversial,but EOS count has been used as a biomarker in clinical practice,especially in COPD patients gaining benefits of improving the prognosis and preventing the deterioration of the disease after inhaling corticosteroids.In addition,a variety of treatment methods for eosinophilic inflammation have been or are being researched and developed,including monoclonal antibodies against inflammatory mediators such as interleukin,chemokines and their receptors.This paper reviewed the biological characteristics of EOS,its role in the pathogenesis of COPD and its value as a biomarker in decision-making of individualized treatment.