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Phänotypen und Biomarker von Asthma

Wo stehen wir heute?

Phenotypes and biomarkers of asthma

Where do we stand today?

  • Leitthema
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Zusammenfassung

Die genaue Phänotypisierung von Asthma ist heutzutage essenziell für die effektive Behandlung von Asthmapatienten, die unter einer Monotherapie mit inhalativen Kortikosteroiden (ICS) nicht zu kontrollieren sind. Hier spielen neben klinischen Merkmalen immunologische Parameter eine zunehmende Rolle. Zu diesen immunologischen Biomarkern gehören eosinophile Granulozyten, das Gesamt-IgE und das spezifische IgE im Serum sowie die Fraktion des exhalierten Stickstoffmonoxids (FeNO). Möglicherweise werden demnächst auch weitere Marker, wie der Typ-2-Marker Periostin, in der klinischen Routine zum Einsatz kommen. Bei der klinischen Bewertung von Biomarkern sind allerdings immer noch viele Fragen ungeklärt. Nicht zuletzt durch den zunehmenden Einsatz der Biologika werden wir neue Einblicke in die verschiedenen Formen von Asthma und in die Rolle von Biomarkern beim Management von Asthma erhalten.

Abstract

A precise phenotyping of asthma has become an essential factor in the treatment of patients with asthma who are not well-controlled despite treatment with inhaled corticosteroids (ICS). In this regard, there is an increasing role for immunologic biomarkers such as eosinophils, total and specific IgE in serum and exhaled nitric oxide (FeNO). In the future, additional markers such as the type 2 marker periostin may become available in clinical practice. Of note, there are several unanswered questions regarding the clinical relevance of biomarkers in severe asthma. However, as a consequence of the increasing use of biologicals in clinical practice, we will gain new insights into the different phenotypes of asthma and the role of biomarkers in asthma management.

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Authors and Affiliations

  1. Abteilung für Pneumologie und Internistische Intensivmedizin, Zentrum für Innere Medizin, Universitätsklinikum Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland

    M. Lommatzsch

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Correspondence to M. Lommatzsch.

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M. Lommatzsch erhielt Honorare für Beratungen und Vorträge von den Firmen ALK Abelló, Allergopharma, Astra Zeneca, Bencard, Berlin-Chemie, Boehringer-Ingelheim, Boston Scientic, Chiesi, GSK, Janssen-Cilag, MSD, Mundipharma, Novartis, Nycomed/Takeda, Sanofi, TEVA, UCB.

Dieser Beitrag beinhaltet keine vom Autor durchgeführten Studien an Menschen oder Tieren.

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M. Lommatzsch, Rostock

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Lommatzsch, M. Phänotypen und Biomarker von Asthma. Pneumologe 14, 281–286 (2017). https://doi.org/10.1007/s10405-017-0108-z

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  • DOI: https://doi.org/10.1007/s10405-017-0108-z

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