Allergy and refractory asthma: New etiological and treatment pathways

作者:Cleenewerck Alice; Raherison Chantal; Magnan Antoine; Tunon de Lara Jose Manuel*
来源:Presse Medicale, 2008, 37(1): 129-135.
DOI:10.1016/j.lpm.2007.08.007

摘要

Severe asthma is often refractory to standard treatments and presents real problems of management. It necessitates rigorous clinical procedures to identify the aggravating factors.
Allergic factors probably play an important role but ore often ignored; atopy is more often associated with mild or moderate asthma.
The prevalence of severe refractory asthma is not known with any precision, in view of the lack of a consensus definition.
Few studies have examined the role of allergic factors.
From a pathophysiologic perspective, genetic factors ore probably responsible for greater severity and allergic response ploys on important role in some severe asthma phenotypes.
From an environmental perspective, some airborne allergens are associated with the refractory character of the disease. Molds such os Alternaria ore, for example, implicated in the onset of asthma attacks, os ore some occupation of exposure.
Better knowledge of the pathophysiology of refractory asthma and its allergic dimensions hove mode it possible to use new treatment agents, such os omalizumab. New treatment targets are being discovered and evaluated in this domain.

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