目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组...目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组)对比安慰剂+常规治疗(对照组)的随机对照试验,检索时限均为建库起至2020年12月,并同时手工检索相关研究的参考文献。对符合纳入标准的研究进行资料提取后,采用Cochrane系统评价员手册6.1推荐的偏倚评估工具2.0版本对纳入文献的质量进行评价。采用Rev Man 5.4软件进行Meta分析。结果:共纳入5项研究,合计2646例患者。Meta分析结果显示,试验组患者的哮喘急性发作率[RR=0.67,95%CI(0.61,0.74),P<0.00001]、哮喘控制问卷评分[MD=-0.29,95%CI(-0.37,-0.21),P<0.00001]、严重不良事件发生率[RR=0.67,95%CI(0.53,0.84),P=0.0006]均显著低于对照组,第1秒用力呼气量[MD=0.13,95%CI(0.09,0.17),P<0.00001]、哮喘生活质量问卷评分[MD=0.23,95%CI(0.13,0.33),P<0.00001]均显著高于对照组,而两组患者的不良事件发生率比较差异无统计学意义[RR=0.97,95%CI(0.92,1.02),P=0.28]。结论:贝那利珠单抗治疗重度嗜酸粒细胞性哮喘患者安全、有效。但因数据相对有限,该结论还有待更多的研究来证实。展开更多
哮喘是一种慢性炎症性气道疾病,主要由不同的CD4^(+)T细胞亚群[辅助性T细胞(helper T cell,Th细胞)]驱动。CD4^(+)T细胞亚群是一类重要的免疫细胞,能够分泌多种细胞因子,调节机体对各种抗原的免疫反应。根据分泌的细胞因子的不同,CD4^(...哮喘是一种慢性炎症性气道疾病,主要由不同的CD4^(+)T细胞亚群[辅助性T细胞(helper T cell,Th细胞)]驱动。CD4^(+)T细胞亚群是一类重要的免疫细胞,能够分泌多种细胞因子,调节机体对各种抗原的免疫反应。根据分泌的细胞因子的不同,CD4^(+)T细胞可以分为Th1、Th2、Th17、滤泡性辅助性T细胞(follicular helper T cell,Tfh细胞)和调节性T细胞(regulatory T cell,Treg细胞)等亚群,它们在哮喘的发生发展中起着不同的作用。生物治疗是一种针对特定分子和途径的新治疗手段,为哮喘患者提供了更多的选择。生物制剂是一类利用生物技术制备的药物,能够特异性地识别和中和目标分子,从而干预相关的信号通路。该文回顾了各种CD4^(+)T细胞亚群在哮喘表型中的角色及分子机制,总结了嗜酸性粒细胞哮喘、中性粒细胞哮喘、混合性哮喘的免疫病理学特征和针对Th2、Th1、Th17、Tfh、Treg细胞相关因子的生物制剂的临床效果和安全性,以及相应生物制剂的选择和发展方向;并讨论了Treg细胞受损和树突状细胞(dendritic cell,DC)异常在哮喘发病机制中的作用,以及利用这些细胞的免疫治疗潜力。该文旨在为哮喘生物治疗的个性化选择和新药开发提供参考。展开更多
Objective To explore the impacts of acupuncture on leukocyte （LEU） and eosinophilic granulocyte （EOS） in bronchoalveolar lavage fluid （BALF） in asthma model rats. Methods Thirty SPF-grade male SD rats were rando...Objective To explore the impacts of acupuncture on leukocyte （LEU） and eosinophilic granulocyte （EOS） in bronchoalveolar lavage fluid （BALF） in asthma model rats. Methods Thirty SPF-grade male SD rats were randomized into a blank group, a model group and an acupuncture group, 10 rats in each one. In the acupuncture group and the model group, the intraperitoneal injection of ovalbumin （OVA） was adopted to establish asthma model. In the model group, only the animal model was established but no intervention of acupuncture was given, in the acupuncture group, at the same time of the model establishment, acupuncture was provided at Dazhui （大椎 GV 14）, Feishu （肺俞 BL 13） and Fengmen （风门 BL 22）. The intervention was given once every two days, totally 7 treatments were required （2 weeks）. In the blank group, no any management was applied. The lung lavage method was adopted to collect BALF after 2 weeks for the rats in each group. Under optical microscope, the total LEU count was calculated. With Wright＇s staining, the total EOS count was calculated. Results In the model group, LEU and EOS counts in BALF in the rats were increased apparently compared with the blank group （both P〈0.05）. LEU and EOS counts in BALF in the rats in the acupuncture group were reduced apparently compared with the model group （both P〈0.05）. In BALF, the proportion of EOS in LEU in the rats in the model group was higher than that in the blank group （P〈0.05）. In BALF, the proportion of EOS in LEU in the rats in the acupuncture group was lower than that in the model group （P〈0.05）. Conclusion Acupuncture intervention reduces apparently LEU and EOS counts in BALF in asthma model rats so that asthma is relieved.展开更多
文摘目的:系统评价贝那利珠单抗治疗重度嗜酸粒细胞性哮喘的疗效和安全性,为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、ClinicalTrials.gov、中国知网、维普网和万方数据等,收集贝那利珠单抗+常规治疗(试验组)对比安慰剂+常规治疗(对照组)的随机对照试验,检索时限均为建库起至2020年12月,并同时手工检索相关研究的参考文献。对符合纳入标准的研究进行资料提取后,采用Cochrane系统评价员手册6.1推荐的偏倚评估工具2.0版本对纳入文献的质量进行评价。采用Rev Man 5.4软件进行Meta分析。结果:共纳入5项研究,合计2646例患者。Meta分析结果显示,试验组患者的哮喘急性发作率[RR=0.67,95%CI(0.61,0.74),P<0.00001]、哮喘控制问卷评分[MD=-0.29,95%CI(-0.37,-0.21),P<0.00001]、严重不良事件发生率[RR=0.67,95%CI(0.53,0.84),P=0.0006]均显著低于对照组,第1秒用力呼气量[MD=0.13,95%CI(0.09,0.17),P<0.00001]、哮喘生活质量问卷评分[MD=0.23,95%CI(0.13,0.33),P<0.00001]均显著高于对照组,而两组患者的不良事件发生率比较差异无统计学意义[RR=0.97,95%CI(0.92,1.02),P=0.28]。结论:贝那利珠单抗治疗重度嗜酸粒细胞性哮喘患者安全、有效。但因数据相对有限,该结论还有待更多的研究来证实。
文摘哮喘是一种慢性炎症性气道疾病,主要由不同的CD4^(+)T细胞亚群[辅助性T细胞(helper T cell,Th细胞)]驱动。CD4^(+)T细胞亚群是一类重要的免疫细胞,能够分泌多种细胞因子,调节机体对各种抗原的免疫反应。根据分泌的细胞因子的不同,CD4^(+)T细胞可以分为Th1、Th2、Th17、滤泡性辅助性T细胞(follicular helper T cell,Tfh细胞)和调节性T细胞(regulatory T cell,Treg细胞)等亚群,它们在哮喘的发生发展中起着不同的作用。生物治疗是一种针对特定分子和途径的新治疗手段,为哮喘患者提供了更多的选择。生物制剂是一类利用生物技术制备的药物,能够特异性地识别和中和目标分子,从而干预相关的信号通路。该文回顾了各种CD4^(+)T细胞亚群在哮喘表型中的角色及分子机制,总结了嗜酸性粒细胞哮喘、中性粒细胞哮喘、混合性哮喘的免疫病理学特征和针对Th2、Th1、Th17、Tfh、Treg细胞相关因子的生物制剂的临床效果和安全性,以及相应生物制剂的选择和发展方向;并讨论了Treg细胞受损和树突状细胞(dendritic cell,DC)异常在哮喘发病机制中的作用,以及利用这些细胞的免疫治疗潜力。该文旨在为哮喘生物治疗的个性化选择和新药开发提供参考。
文摘Objective To explore the impacts of acupuncture on leukocyte （LEU） and eosinophilic granulocyte （EOS） in bronchoalveolar lavage fluid （BALF） in asthma model rats. Methods Thirty SPF-grade male SD rats were randomized into a blank group, a model group and an acupuncture group, 10 rats in each one. In the acupuncture group and the model group, the intraperitoneal injection of ovalbumin （OVA） was adopted to establish asthma model. In the model group, only the animal model was established but no intervention of acupuncture was given, in the acupuncture group, at the same time of the model establishment, acupuncture was provided at Dazhui （大椎 GV 14）, Feishu （肺俞 BL 13） and Fengmen （风门 BL 22）. The intervention was given once every two days, totally 7 treatments were required （2 weeks）. In the blank group, no any management was applied. The lung lavage method was adopted to collect BALF after 2 weeks for the rats in each group. Under optical microscope, the total LEU count was calculated. With Wright＇s staining, the total EOS count was calculated. Results In the model group, LEU and EOS counts in BALF in the rats were increased apparently compared with the blank group （both P〈0.05）. LEU and EOS counts in BALF in the rats in the acupuncture group were reduced apparently compared with the model group （both P〈0.05）. In BALF, the proportion of EOS in LEU in the rats in the model group was higher than that in the blank group （P〈0.05）. In BALF, the proportion of EOS in LEU in the rats in the acupuncture group was lower than that in the model group （P〈0.05）. Conclusion Acupuncture intervention reduces apparently LEU and EOS counts in BALF in asthma model rats so that asthma is relieved.
