Современное представление о бронхиальной астме с фиксированной обструкцией

Крапошина А.Ю., Собко Е.А., Демко И.В., Кацер А.Б., Казмерчук О.В., Абрамов Ю.И. Современное представление о бронхиальной астме с фиксированной обструкцией. Терапевтический архив. 2021; 93 (3): 337–342. DOI: 10.26442/00403660.2021.03.200661

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Kraposhina AYu, Sobko EA, Demko IV, Kacer AB, Kazmerchuk OV, Abramov YuI. Modern understanding of bronchial asthma with fixed airflow obstruction. Terapevticheskii Arkhiv (Ter. Arkh.). 2021; 93 (3): 337–342.
DOI: 10.26442/00403660.2021.03.200661

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Аннотация

В обзоре приведены данные по одному из фенотипов тяжелой бронхиальной астмы (БА) – астме с фиксированной обструкцией дыхательных путей (ФОДП). По опубликованным сегодня данным, не существует одного пути формирования ФОДП у пациентов с тяжелой БА. Углубление знаний о патофизиологии ФОДП, а также выявление наиболее значимых факторов риска необходимы для успешного лечения таких пациентов. Кроме того, развитие фиксированной обструкции ассоциировано с худшим, а порой и фатальным прогнозом. Расширение имеющихся представлений необходимо также для преодоления трудностей дифференциальной диагностики между БА с ФОДП и БА в сочетании c хронической обструктивной болезнью легких. Все это позволит оптимизировать подход к ведению больных БА для предупреждения формирования ФОДП.

Ключевые слова: фенотип, тяжелая бронхиальная астма, астма с фиксированной обструкцией дыхательных путей

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The review provides data on one of the phenotypes of severe bronchial asthma – it is asthma with fixed airway obstruction. According to data published today, there is no single pathway for the formation of fixed airway obstruction in patients with severe asthma. Increasing knowledge of the pathophysiology of fixed airway obstruction, as well as identifying the most significant risk factors, is essential for the successful treatment of such patients. In addition, the development of fixed obstruction is associated with a worse and sometimes fatal prognosis. Expanding the existing views is also necessary to overcome the difficulties of differential diagnosis between bronchial asthma with fixed airway obstruction and bronchial asthma in combination with COPD. All this will optimize the approach to the management of patients with bronchial asthma to prevent the formation of fixed airway obstruction.

Keywords: phenotype, severe bronchial asthma, asthma with fixed airflow obstruction

Список литературы

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19. Chipps BE, Hirsch I, Trudo F, et al. Benralizumab efficacy for patients with fixed airflow obstruction and severe, uncontrolled eosinophilic asthma. Ann Allergy Asthma Immunol. 2020;124(1):79-86. doi: 10.1016/j.anai.2019.10.006
20. Oshita Y, Koga T, Kamimura T, et al. Increased circulating 92 kDa matrix metalloproteinase (MMP-9) activity in exacerbations of asthma. Thorax. 2003;58:757-60. doi: 10.1136/thorax.58.9.757
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24. Rawy AM, Mansour AI. Fraction of exhaled nitric oxide measurement as a biomarker in asthma and COPD compared with local and systemic inflammatory markers. Egypt J Chest Dis Tuberculosis. 2015;64:13-20. doi: 10.1016/j.ejcdt.2014.09.004
25. Uzan GC, Borekci S, Doventas YE, et al. The relationship between inflammatory markers and spirometric parameters in ACOS, Asthma, and COPD. J Asthma. 2019;12:1-7. doi: 10.1080/02770903.2019.1652644
26. Grzela K, Litwiniuk M, Zagorska W, Grzela T. Airway remodeling in chronic obstructive pulmonary disease and asthma: the role of matrix metalloproteinase-9. Arch Immunol Ther Exp. 2016;64(1):47-55. doi: 10.1007/s00005-015-0345-y
27. Rogliani P, Ora J, Puxeddu E, Cazzola M. Airflow obstruction: is it asthma or is it COPD? Int J Chron Obstruct Pulmon Dis. 2016;11:3007-13. doi: 10.2147/COPD.S54927
28. Kitaguchi Y, Yasuo M, Hanaoka M. Comparison of pulmonary function in patients with COPD, asthma-COPD overlap syndrome, and asthma with airflow limitation. Int J Chron Obstruct Pulmon Dis. 2016;11:991-7. doi: 10.2147/COPD.S105988
29. Jones RL, Noble PB, Elliot JG, James AL. Airway remodelling in COPD: It’s not asthma! Respirology. 2016;21(8):1347-56. doi: 10.1111/resp.12841
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33. Gross NJ, Barnes PJ. New therapies for asthma and chronic obstructive pulmonary disease. Am J Respir Critical Care Med. 2017;195(2):159-66. doi: 10.1164/rccm.201610-2074PP

________________________________________________

1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention (2019 update). Available at: www.ginasthma.org. Accessed : 16.07.2019.
2. Avdeev SN, Nenasheva NM, Zhudenkov KV, et al. Prevalence, morbidity, phenotypes and other characteristics of severe bronchial asthma in Russian Federation. Pulmonology. 2018;28(3):341-58 (In Russ.) doi: 10.18093/0869-0189-2018-28-3-341-358
3. Konstantellou E, Papaioannou AI, Loukides S, et al. Persistent airflow obstruction in patients with asthma: Characteristics of a distinct clinical phenotype. Respir Med. 2015;109:1404-9. doi: 10.1016/j.rmed.2015.09.009
4. Ciebiada M, Domagała M, Gorska-Ciebiada M, Gorski P. Risk factors associated with irreversible airway obstruction in nonsmoking adult patients with severe asthma. Allergy Asthma Proc. 2014;35(5):72-9. doi: 10.2500/aap.2014.35.3785
5. Bennett GH, Carpenter L, Hao W, et al. Risk factors and clinical outcomes associated with fixed airflow obstruction in older adults with asthma. Ann Allergy Asthma Immunol. 2018;120(2):164-8. doi: 10.1016/j.anai.2017.10.004
6. Tashkin DP, Moore GE, Trudo F, et al. Assessment of Consistency of Fixed Airflow Obstruction Status during Budesonide/Formoterol Treatment and Its Effects on Treatment Outcomes in Patients with Asthma. J Allergy Clin Immunol Pract. 2016;4(4):705-12. doi: 10.1016/j.jaip.2016.02.014
7. Haddad A, Gaudet M, Plesa M, et al. Neutrophils from severe asthmatic patients induce epithelial to mesenchymal transition in healthy bronchial epithelial cells. Respir Res. 2019;20(1):234. doi: 10.1186/s12931-019-1186-8
8. Wang L, Gao S, Zhu W, Su J. Risk factors for persistent airflow limitation: analysis of 306 patients with asthma. Pak J Med Sci. 2014;30(6):1393-7.
doi: 10.12669/pjms.306.5363
9. Ten Brinke A, Zwinderman AH, Sterk PJ, et al. Persistent airflow limitation in asthma. Am J Respir Crit Care Med. 2001;164(5):744-8. doi: 10.1164/ajrccm.164.5.2011026
10. Mogensen I, Alving K, Dahlen SE, et al. Fixed airflow obstruction relates to eosinophil activation in asthmatics. Clin Exp Allergy. 2019;49(2):155-62. doi: 10.1111/cea.13302
11. Kolobovnikova YuV, Urazova OI, Novitsky VV, et al. Eosinophil: a modern concept of the kinetics, structure and function. Russian journal of hematology and transfusiology. 2012;57(1):30-6 (In Russ.)
12. Domingo C, Palomares O, Sandham DA, et al. The prostaglandin D2 receptor 2 pathway in asthma: a key player in airway inflammation. Respir Res. 2018;19:189. doi: 10.1186/s12931-018-0893-x
13. Takahashi K, Meguro K, Kawashima H, et al. Serum periostin levels serve as a biomarker for both eosinophilic airway inflammation and fixed airflow limitation in well-controlled asthmatics. J Asthma. 2019;56(3):236-43.
doi: 10.1080/02770903.2018.1455855
14. Shaw DE, Berry MA, Hargadon B, et al. Association between neutrophilic airway inflammation and airflow limitation in adults with asthma. Chest. 2007;132(6):1871-5.
doi: 10.1378/chest.07-1047
15. Pain M, Bermudez O, Lacoste P, et al. Tissue remodelling in chronic bronchial diseases: from the epithelial to mesenchymal phenotype. Eur Respir Rev. 2014;23(131):118-30. doi: 10.1183/09059180.00004413
16. Jarjour NN, Konno S. Mechanisms underlying fixed airflow obstruction and exacerbations. In: Chung KF, Israel E, Gibson PG, eds. Severe asthma. Sheffield, European Respiratory Society, 2019:82-92.
17. Miravitlles M. Diagnosis of asthma–COPD overlap: the five commandments. Eur Respir J. 2017;49(5):1700506. doi: 10.1183/13993003.00506-2017
18. Fedoseev GB, Trofimov VI, Negrutsa KV, et al. Is ACOS an independent nosology? Clinical signs and diagnosis of ACOS. Russian Pulmonology. 2018;28(5):519-29 (In Russ.) doi: 10.18093/0869-0189-2018-28-5-519-529
19. Chipps BE, Hirsch I, Trudo F, et al. Benralizumab efficacy for patients with fixed airflow obstruction and severe, uncontrolled eosinophilic asthma. Ann Allergy Asthma Immunol. 2020;124(1):79-86. doi: 10.1016/j.anai.2019.10.006
20. Oshita Y, Koga T, Kamimura T, et al. Increased circulating 92 kDa matrix metalloproteinase (MMP-9) activity in exacerbations of asthma. Thorax. 2003;58:757-60. doi: 10.1136/thorax.58.9.757
21. Tonga KO, Chapman DG, Farah CS, et al. Reduced lung elastic recoil and fixed airflow obstruction in asthma. Respirology. 2019;1-7. doi: 10.1111/resp.13688
22. Ovsyannikov NV, Bilevich OА, Zinchenko LM, Kozlova EA. New opportunities in achievement control over the course of severe bronchial asthma. Vestn. sovremennoi klinicheskoi mediciny. 2019;12(4):63-8 (In Russ.) doi: 10.20969/VSKM.2019.12(4).63-8
23. Katoh S, Ikeda M, Shirai R, et al. Biomarkers for differentiation of patients with asthma and chronic obstructive pulmonary disease. J Asthma. 2018;55(10):1052-8. doi: 10.1080/02770903.2017.1391281
24. Rawy AM, Mansour AI. Fraction of exhaled nitric oxide measurement as a biomarker in asthma and COPD compared with local and systemic inflammatory markers. Egypt J Chest Dis Tuberculosis. 2015;64:13-20. doi: 10.1016/j.ejcdt.2014.09.004
25. Uzan GC, Borekci S, Doventas YE, et al. The relationship between inflammatory markers and spirometric parameters in ACOS, Asthma, and COPD. J Asthma. 2019;12:1-7. doi: 10.1080/02770903.2019.1652644
26. Grzela K, Litwiniuk M, Zagorska W, Grzela T. Airway remodeling in chronic obstructive pulmonary disease and asthma: the role of matrix metalloproteinase-9. Arch Immunol Ther Exp. 2016;64(1):47-55. doi: 10.1007/s00005-015-0345-y
27. Rogliani P, Ora J, Puxeddu E, Cazzola M. Airflow obstruction: is it asthma or is it COPD? Int J Chron Obstruct Pulmon Dis. 2016;11:3007-13. doi: 10.2147/COPD.S54927
28. Kitaguchi Y, Yasuo M, Hanaoka M. Comparison of pulmonary function in patients with COPD, asthma-COPD overlap syndrome, and asthma with airflow limitation. Int J Chron Obstruct Pulmon Dis. 2016;11:991-7. doi: 10.2147/COPD.S105988
29. Jones RL, Noble PB, Elliot JG, James AL. Airway remodelling in COPD: It’s not asthma! Respirology. 2016;21(8):1347-56. doi: 10.1111/resp.12841
30. Nenasheva NM. Biomarker-based therapy of asthma. Prakticheskaya pul’monologiya. 2018;4:3-11 (In Russ.)
31. Vorzheva II, Khashkina LA. Omalizumab rike in therapy of grave therapeutically resistent allergic asthma with involvement of small respiratory ways and fixed bronchial obstruction. a literature review and clinical observation. Med. sovet. 2017;18:39-43 (In Russ.) doi: 10.21518/2079-701x-2017-18-39-43
32. Demko IV, Sobko EA, Chubarova SV, et al. Features of the systemic inflammation, external respiration functions and morphological structure of the bronchial mucous membrane in severe bronchial asthma. Siberian Medical Review. 2014;5:47-52 (In Russ.) doi: 10.20333/25000136-2014-5-47-52
33. Gross NJ, Barnes PJ. New therapies for asthma and chronic obstructive pulmonary disease. Am J Respir Critical Care Med. 2017;195(2):159-66. doi: 10.1164/rccm.201610-2074PP

Авторы

А.Ю. Крапошина*1,2, Е.А. Собко1,2, И.В. Демко1,2, А.Б. Кацер1, О.В. Казмерчук1, Ю.И. Абрамов1

1 ФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого» Минздрава России, Красноярск, Россия;
2 КГБУЗ «Краевая клиническая больница», Красноярск, Россия
*angelina-maria@inbox.ru

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Angelina Yu. Kraposhina*1,2, Elena A. Sobko1,2, Irina V. Demko1,2, Anna B. Kacer1, Olga V. Kazmerchuk1, Yuriy I. Abramov1

1 Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia;
2 Regional Clinical Hospital, Krasnoyarsk, Russia
*angelina-maria@inbox.ru

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