MEDIX, God. 27 Br. 149  •  Pregledni članak  •  Alergologija i klinička imunologija HR ENG

Astma tipa 2Type 2 asthma

Marinko Artuković, Vesna Vukičević Lazarević, Ivan Marković

Astma je heterogena bolest s različitim fenotipovima i endotipovima, koja se očituje kroničnom upalom, hiperreaktivnošću i varijabilnom opstrukcijom bronha. Prema patofiziološkom mehanizmu, astmu se dijeli u dva glavna endotipa: T2 astma i ne-T2 astma. U bolesnika s teškom astmom, a s obzirom na dostupnost jednostavnih bioloških biljega i ciljane terapije, ova je podjela osobito važna. Na razini fenotipa T2, astma je obilježena atopijom i/ili eozinofilnom upalnom dišnih puteva. Biološki lijekovi koji ciljano blokiraju ključne posrednike upale tipa 2 (IgE, citokin IL-5, receptori citokina IL-5 i IL-4/IL-13) znatno su unaprijedili liječenje i ishode u bolesnika s teškom T2 astmom.

Ključne riječi:
teška astma; endotip; biološki lijekovi; monoklonska protutijela

Članak u cijelosti pročitajte u tiskanom izdanju MEDIX, God. 27 Br. 149

Asthma is a heterogeneous disease with different phenotypes and endotypes, manifested by chronic inflammation, hyperreactivity, and variable bronchial obstruction. Based on the pathophysiologic mechanism, two main asthma endotypes can be distinguished: T2-high and T2-low. In patients with severe asthma, and given the availability of simple biological markers and targeted therapy, this division is particularly important. At the T2-phenotype level, asthma is characterized by atopy and/or eosinophilic airway inflammation. Biologic drugs targeting and inhibiting key mediators of type 2 inflammation (IgE, IL-5, IL-5 and IL-4/IL-13 receptors) have significantly improved treatment and outcomes in patients with severe T2 asthma.

Key words:
biologics; endotype; monoclonal antibodies; severe asthma