BIOMARKERI U INFLAMATORNIM FENOTIPOVIMA ASTME

  • aleksandra_plavsic Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija
DOI: https://doi.org/10.5937/mp75-47473
Ključne reči: fenotip, biomarkeri, T2 astma, non T2 astma

Sažetak


Astmu karakterišu raznovrsnost i varijabilnost patofizioloških mehanizama, kliničke prezentacije, odgovora na terapiju, nepredvidivost egzarcebacija. Danas se astma posmatra kao sindrom koji čine skup različitih endotipova i fenotipova. Fenotip odražava sve bitne odlike astme i prema konceptu personalizovane medicine, treba ga definisati za svakog pacijenta i odrediti ciljani terapijski pristup. Na osnovu analize indukovanog sputuma, koji koreliše sa inflamacijom u disajnim putevima, utvrđena su 4 inflamatorna fenotipa: eozinofilni, neutrofilni, mešoviti i paucogranulocitni. Evaluacijom ključnih molekularnih odlika u astmi, definisana su 2 fenotipa:  tip 2 (T2) i non tip 2 (non T2). Značajnu ulogu u definisanju fenotipova imaju biomarkeri koji su indikatori patološkog procesa i kliničkog odgovora na terapiju, a trebalo bi da budu lako dostupni. Za sada nisu tačno i precizno određeni svi T2 biomarkeri, a najviše istraživani i sa najvećim potencijalom determinisanja T2 fenotipa su eozinofili, frakcija izdahnutog azot oksida (FeNO) i IgE, dok non T2 biomarkeri nisu opisani. Imajući u vidu da se fenotipovi mogu preklapati i menjati čini definisanje biomarkera koji reprezentuju sve karakteristike fenotipa teškim i zahtevnim. Sa druge strane, određivanje biomarkera predstavlja  veliki izazov u budućim istraživanjima, naročito kada se ima u vidu prevalenca astme u svetu.

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2025/02/23
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Vol. 75 Br. 4 (2024): Medicinski podmladak
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