medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-121medsovet-9190Research ArticleХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ЛЕГКИХCHRONIC PULMONARY DISEASESКлинический случай включения тезепелумаба в лечение тяжелой не-Т2 бронхиальной астмыClinical case of integrating tezepelumab in the treatment of non-T2 severe bronchial asthmahttps://orcid.org/0000-0001-9928-926XГайнитдиноваВ. В.GaynitdinovaV. V.

Гайнитдинова Вилия Вилевна, д.м.н., профессор кафедры пульмонологии Института клинической медицины имени Н.В. Склифосовского

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Viliya Gaynitdinova, Dr. Sci. (Med.), Professor, Department of Pulmonology, N.V. Sklifosovsky Institute of Clinical Medicine

8, Bldg. 2, Trubetskaya St., Moscow, 119991

ivv_08@mail.ruhttps://orcid.org/0000-0002-3174-5000МержоеваЗ. М.MerzhoevaZ. M.

Мержоева Замира Магомедовна, к.м.н., доцент кафедры пульмонологии; заведующая пульмонологическим отделением

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Zamira M. Merzhoeva, Cand. Sci. (Med.), Associate Professor, Pulmonology Department

8, Bldg. 2, Trubetskaya St., Moscow, 119991

merzhoeva_z_m@staff.sechenov.ruhttps://orcid.org/0000-0002-4726-4906НуралиеваГ. С.NuralievaG. S.

Нуралиева Галия Сериковна, к.м.н., доцент кафедры пульмонологии Института клинической медицины имени Н.В. Склифосовского

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Galiya S. Nuralieva, Cand. Sci. (Med.), Associate Professor, Department of Pulmonology, N.V. Sklifosovsky Institute of Clinical Medicine

8, Bldg. 2, Trubetskaya St., Moscow, 119991

nuralieva_g@staff.sechenov.ruhttps://orcid.org/0009-0004-9275-2601СоколоваЕ. С.SokolovaE. S.

Соколова Елизавета Сергеевна, ординатор кафедры пульмонологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Elizaveta S. Sokolova, Resident of the Department of Pulmonology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

e-li1999@mail.ruБогатыреваТ. У.BogatyrevaT. U.

Богатырева Тамара Умаровна, аспирант кафедры пульмонологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Tamara U. Bogatyreva, Pоstgraduate Student of the Department of Pulmonology

8, Bldg. 2, Trubetskaya St., Moscow, 119991

toma.bogatyrva.97@inbox.ruhttps://orcid.org/0000-0002-1314-0091ШмидтА. Е.ShmidtA. E.

Шмидт Анна Евгеньевна, ассистент кафедры пульмонологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Anna E. Shmidt, Assistant of the Department of Pulmonology 

8, Bldg. 2, Trubetskaya St., Moscow, 119991

shmidt_a_e@staff.sechenov.ruhttps://orcid.org/0000-0002-5999-2150АвдеевС. Н.AvdeevS. N.

Авдеев Сергей Николаевич, д.м.н., профессор, академик РАН, заведующий кафедрой пульмонологии Института клинической медицины имени Н.В. Склифосовского; директор НМИЦ пульмонологии Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); руководитель клинического отдела, Научно-исследовательский институт пульмонологии Федерального медико-биологического агентства

119991, Москва, ул. Трубецкая, д. 8, стр. 2,

115682, Москва, Ореховый бульвар, д. 28

Sergey N. Avdeev, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the Pulmonology Department, N.V. Sklifosovsky Institute of Clinical Medicine; Director of the National Medical Research Center of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University); Head of the Clinical Department, Research Institute for Pulmonology of the Federal Medical Biological Agency

8, Bldg. 2, Trubetskaya St., Moscow, 119991,

8, Orekhovy Boulevard, Moscow, 115682

serg_avdeev@list.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov UniversityRussian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); Научно-исследовательский институт пульмонологии Федерального медико-биологического агентстваРоссияSechenov First Moscow State Medical University (Sechenov University); Research Institute for Pulmonology of the Federal Medical Biological AgencyRussian Federation202522062025092429Copyright © Гайнитдинова В.В., Мержоева З.М., Нуралиева Г.С., Соколова Е.С., Богатырева Т.У., Шмидт А.Е., Авдеев С.Н., 20252025Гайнитдинова В.В., Мержоева З.М., Нуралиева Г.С., Соколова Е.С., Богатырева Т.У., Шмидт А.Е., Авдеев С.Н.Gaynitdinova V.V., Merzhoeva Z.M., Nuralieva G.S., Sokolova E.S., Bogatyreva T.U., Shmidt A.E., Avdeev S.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9190

Бронхиальная астма (БА) – гетерогенное заболевание, от которого страдают порядка 339 млн человек по всему миру. У большинства пациентов астму можно контролировать с помощью стандартных методов лечения, включая ингаляционные кортикостероиды (ИГКС), бета-агонисты длительного действия (β2-агонисты длительного действия), антихолинергические препараты длительного действия (АХДД) и пероральные антагонисты лейкотриеновых рецепторов. Для более тяжелых случаев, которые остаются неконтролируемыми при стандартном лечении, в настоящее время доступна генно-инженерная биологическая терапия (ГИБТ). Существующие генно-биологические препараты подавляют только определенные молекулярные мишени, такие как IgE и цитокины профиля T-2 воспаления, подходят для небольшой группы пациентов с тяжелой формой астмы и неэффективны при неаллергических или неэозинофильных фенотипах (не Т2) астмы. Однако эти биологические препараты подходят только для группы пациентов с тяжелой Т-2 БА и неэффективны при неаллергических или неэозинофильных фенотипах астмы. Неоднородная реакция на лечение астмы напрямую связана с различиями в характере воспаления дыхательных путей, активации иммунных клеток и чувствительности к глюкокортикоидам. Тезепелумаб – это первое в своем классе моноклональное антитело к тимическому стромальному лимфопоэтину (TSLP), которое назначается при ТБА, независимо от эндотипа воспаления. В представленном клиническом наблюдении включение тезепелумаба в лечение тяжелой неатопической неэозинофильной (не Т-2) неконтролируемой астмы привело к полному контролю симптомов БА, значительному улучшению функции внешнего дыхания и не вызвало нежелательных явлений. Полученные данные совпали с результатами проведенных исследований.

Asthma is a heterogeneous disease that affects approximately 339 million people worldwide. In most patients, asthma can be controlled with standard treatments, including inhaled corticosteroids (ICS), long-acting beta-agonists (LABs), long-acting anticholinergics (LACs), and oral leukotriene receptor antagonists. For more severe cases that remain uncontrolled with standard treatment, gene-engineered therapies (GEBTs) are now available. Existing gene-engineered therapies only inhibit specific molecular targets, such as IgE and T-2 inflammatory cytokines, are suitable for a small subset of patients with severe asthma, and are ineffective in non-allergic or non-eosinophilic (non-T2) asthma phenotypes. However, these biological drugs are only suitable for a group of patients with severe T-2 bronchial asthma and are ineffective in non-allergic or non-eosinophilic asthma phenotypes. Heterogeneous response to asthma treatment is directly related to differences in the nature of airway inflammation, immune cell activation, and glucocorticoid sensitivity. Tezepelumab is a first-in-class monoclonal antibody to thymic stromal lymphopoietin (TSLP) that is prescribed for sever asthma, regardless of the endotype of inflammation. In the presented clinical observation, the inclusion of tezepelumab in the treatment of severe non-atopic non-eosinophilic (non-T-2) uncontrolled asthma led to complete control of asthma symptoms, significant improvement in respiratory function, and did not cause adverse events. The data obtained coincided with the results of the studies.

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The authors declare that there are no conflicts of interest present.