Эозинофильная хроническая обструктивная болезнь легких

Анаев Э.Х. Эозинофильная хроническая обструктивная болезнь легких. Терапевтический архив. 2023;95(8):696–700. DOI: 10.26442/00403660.2023.08.202316

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Anaev EKh. Eosinophilic chronic obstructive pulmonary disease: A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(8):696–700. DOI: 10.26442/00403660.2023.08.202316

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Аннотация

За последние десятилетия хроническая обструктивная болезнь легких (ХОБЛ) стала важнейшей проблемой общественного здравоохранения в связи с ростом заболеваемости и смертности. ХОБЛ характеризуется ограничением скорости воздушного потока из-за воспаления бронхиального дерева и ремоделирования мелких дыхательных путей. У 20–40% пациентов с ХОБЛ наблюдается эозинофильное воспаление дыхательных путей, как и при бронхиальной астме. Недавно показано, что эозинофильная ХОБЛ является отдельным заболеванием и связана с более выраженным ремоделированием дыхательных путей. Хотя роль эозинофилов в патогенезе ХОБЛ полностью не выяснена, уровень эозинофилов может использоваться при прогнозе и назначении кортикостероидов, причем их эффективность выше при эозинофилии. В настоящее время моноклональные антитела, направленные против интерлейкина-5, 4 и 13 или их рецепторов, проходят апробацию при Т2-эндотипе ХОБЛ. Данный обзор посвящен механизмам эозинофилии при ХОБЛ, использованию эозинофилов крови и мокроты в качестве биомаркера, а также целесообразности применения моноклональных антител при лечении эозинофильной ХОБЛ.

Ключевые слова: хроническая обструктивная болезнь легких, эозинофил, воспаление, биомаркер, лечение, кортикостероиды, обзор

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Over the past decades, chronic obstructive pulmonary disease (COPD) has become a major public health problem due to increasing morbidity and mortality. COPD is characterized by airflow limitation due to inflammation of the bronchial tree and remodeling of the small airways. In 20–40% of patients with COPD, eosinophilic inflammation of the airways is observed, as in bronchial asthma. Eosinophilic COPD has recently been shown to be a distinct disease and is associated with more pronounced airway remodeling. Although the role of eosinophils in the pathogenesis of COPD is not fully understood, the level of eosinophils can be used in the prognosis and administration of corticosteroids, and their effectiveness is higher in eosinophilia. Currently, monoclonal antibodies directed against interleukins (IL-5, IL-4 and IL-13) or their receptors are being tested in the T2 endotype of COPD. This review focuses on the mechanisms of eosinophilia in COPD, the use of blood and sputum eosinophils as a biomarker, and the advisability of using monoclonal antibodies in the treatment of eosinophilic COPD.

Keywords: chronic obstructive pulmonary disease, eosinophil, inflammation, biomarker, treatment, corticosteroids, review

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Авторы

Э.Х. Анаев*

ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*el_anaev@hotmail.com

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Eldar Kh. Anaev*

Pirogov Russian National Research Medical University, Moscow, Russia
*el_anaev@hotmail.com

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