airways disease phenotyping heterogeneity using measures of airway inflammation呼吸道疾病表型出现异质性使用措施的气道炎症.pdfVIP

REVIEW ARTICLE Airways Disease: Phenotyping Heterogeneity Using Measures of Airway Inflammation Salman Siddiqui, MRCP and Christopher E. Brightling, MRCP, PhD Despite asthma and chronic obstructive pulmonary disease being widely regarded as heterogeneous diseases, a consensus for an accurate system of classification has not been agreed. Recent studies have suggested that the recognition of subphenotypes of airway disease based on the pattern of airway inflammation may be particularly useful in increasing our understanding of the disease. The use of non-invasive markers of airway inflammation has suggested the presence of four distinct phenotypes: eosinophilic, neutrophilic, mixed inflammatory and paucigranulocytic asthma. Recent studies suggest that these subgroups may differ in their etiology, immunopathology and response to treatment. Importantly, novel treatment approaches targeted at specific patterns of airway inflammation are emerging, making an appreciation of subphenotypes particularly relevant. New developments in phenotyping inflammation and other facets of airway disease mean that we are entering an era where careful phenotyping will lead to targeted therapy. Key words: asthma, COPD, eosinophil, inflammation, neutrophil sthma and chronic obstructive pulmonary disease composed of a variety of different domains, for example, A (COPD) are the commonest respiratory diseases airflow obstruction (fixed, reversible), AHR, atopy, and managed by pulmonologists. The incidence of asthma airway inflammation. Each patient with airways disease has and COPD continues to rise.1 By 2020, COPD is expected elements from each domain that contributes to the disease. to be the third largest cause of global mortality