Современные методы диагностики и лечения бронхиальной астмы (систематический обзор)

В настоящее время распространенность бронхиальной астмы (БА) во всем мире неуклонно растет. Данные официальной статистики свидетельствуют, что от 5 до 10% случаев в структуре тяжести данного заболевания составляет тяжелая БА и при ее лечении высокими дозами ингаляционными кортикостероидов (ИКС) сохраняются неконтролируемые симптомы у большинства людей, что значительно снижает качество их жизни. Это поддерживает актуальность поиска новых стратегий лечения тяжелой БА. Цель обзора заключалась в проведении анализа и обобщении опубликованных данных о современных подходах диагностики и лечения тяжелой БА.

Используя рекомендации «Предпочтительные элементы отчетности для систематических обзоров и мета-анализов» (PRISMA), были обнаружены 3177 источников. Исключение публикаций, недоступных для просмотра, позволило оставить 578 источников, из которых теме исследования в той или иной степени соответствовали 120 работ. Из них отобраны 63 источника, содержащие необходимую информацию и соответствующие критериям отбора исследования. Из них 28 обзорных и 35 оригинальных исследований (рандомизированные контролируемые, когортные и исследования «случай – контроль»). Представлено описание фенотипов и эндотипов, а также характеристика современных биомаркеров тяжелой БА. Особое внимание уделяется новым подходом лечения тяжелой БА.

Проведенные исследования, систематизированные в данной статье, свидетельствуют о том, что подробное описание фенотипов и эндотипов БА может помочь выявить новые биомаркеры и терапевтические мишени, специфичные для каждого эндотипа. Глубокое знание фенотипа и эндотипа пациента может определить персонализированный подход к терапии тяжелой БА.

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