Медицинский Совет

Расширенный поиск


Полный текст:


В обзоре рассматриваются значение малых дыхательных путей в развитии патологического процесса при бронхиальной астме, влияние дисфункции мелких бронхов на симптомы, частоту обострений и контроль заболевания. Обсуждаются роль малых дыхательных путей как мишени для противовоспалительной терапии, возможности применения мелкодисперсных аэрозолей в лечении астмы. Детально разбираются особенности клинической фармакологии, клинические эффекты и безопасность современного ингаляционного кортикостероида циклесонида.


Об авторе

Р. С. Фассахов
Институт фундаментальной медицины и биологии Казанского (Приволжского) федерального университета

д.м.н., профессор

Список литературы

1. Hyde D et al. Anatomy, pathology and physiology of the tracheobronchial tree: Emphasis on the distal airways. J. Allergy and Clin. Immunology, 2009, 124: S72-S77.

2. Lipworth B, Manoharan A, Anderson W. Unlocking the quiet zone: the small airway asthma phenotype. Lancet Respir Med, 2014, 2: 497-506.

3. Perez T et al. Small airway impairment in moderate to severe asthmatics without significant proximal airway obstruction. Respir Med, 2013, 107(11): 1667-1674.

4. Mahut B et al. Gas trapping is associated with severe exacerbation in asthmatic children. Respir Med, 2010, 104: 1230–1233.

5. Busacker A et al. A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis. Chest, 2009, 135: 48-56.

6. Anderson WJ, Zajda E, Lipworth BJ. Are we overlooking persistent small airways dysfunction in community-managed asthma? Ann Allergy Asthma Immunol, 2012, 109: 185-189.

7. Usmani OS, Singh D, Spinola M, Bizzi A, Barnes PJ. The prevalence of small airways disease in adult asthma: a systematic literature review. Respir Med, 2016, 116: 19-27.

8. Perez T, Chanez P, Dusser D, Devillier P. Small airway impairment in moderate to severe asthmatics without significant proximal airway obstruction. Respir Med, 2013 Nov, 107(11): 1667-1674.

9. Wennergren G, Gustafsson P. Small airway function, exhaled NO and airway hyper-responsiveness in paediatric asthma. Respir Med, 2011, 105(10): 1476-1484.

10. Schiphof-Godart L et al. Development of a tool to recognize small airways dysfunction in asthma (SADT). Health Qual Life Outcomes, 2014 Nov 22, 12: 155.

11. Kaminsky DA, Irvin CG, Gurka DA, et al. Peripheral airway responsiveness to cool, dry air in normal and asthmatic individuals. Am J Respir Crit Care Med, 1995, 152: 1784-1790.

12. Alfieri V et al. Small airway dysfunction is associated to excessive bronchoconstriction in asthmatic patients. Respir Res, 2014, 15(1): 86.

13. Kraft M, Djukanovic R, Wilson S, Holgate ST, Martin RJ. Am J Respir Crit Care Med, 1996, 154: 1505-1510.

14. Lehtimäki L, Kankaanranta H, Saarelainen S, Turjanmaa V, Moilanen E. Eur Respi J, 2002, 20: 841-845.

15. Rao DR et al. The utility of forced expiratory flow between 25% and 75% of vital capacity in predicting childhood asthma morbidity and severity. J Asthma, 2012, 49: 586-592.

16. Mahut B et al. Gas trapping is associated with severe exacerbation in asthmatic children. Respir Med., 2010, 104: 1230-1233.

17. Takeda T et al. Relationship between Small Airway Function and Health Status, Dyspnea and Disease Control in Asthma. Respiration, 2010, 80: 120-126.

18. Pisi R et al. Small airway dysfunction by impulse oscillometry in asthmatic patients with normal forced expiratory volume in the 1st second values. Allergy Asthma Proc, 2013, 34(1): e14-20.

19. Manoharan A et al. Small airway dysfunction is associated with poorer asthma control. Eur Respir J, 2014, 44(5): 1353-1355.

20. Bacharier LB et al. Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function. Am J Respir Crit Care Med, 2004, 170(4): 426-32.

21. Rao DR et al. The utility of forced expiratory flow between 25 % and 75 % of vitalcapacity in predicting childhood asthma morbidity and severity. J Asthma, 2012, 49: 586-592.

22. Shi Y et al. Relating small airways to asthma control by using impulseoscillometry in children. J Allergy Clin Immunol, 2012, 129: 671-678.

23. Shi Y, Aledia AS, Galant SP, George SC. Peripheral airway impairment measured by oscillometry predicts loss of asthma control in children. J Allergy Clin Immunol, 2013, 131: 718-723.

24. Labiris N, Dolovich M. Pulmonary drug delivery. Part I: Physiological factors affecting therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol, 2003 Dec, 56(6): 588-599.

25. Chrystyn H. Anatomy and physiology in delivery: can we define our targets? Allergy, 1999, 54(suppl 49): 82-87.

26. Usmani OS, Biddiscombe MF, Barnes PJ. Regional lung deposition and bronchodilator response as a function of beta2-agonist particlesize. Am J Respir Crit Care Med, 2005, 172: 1497-1504.

27. Usmani O. Treating the Small Airways. Respiration, 2012, 84: 441-453.

28. Leach CL, Kuehl PJ, Chand R, McDonald JD. Respiratory Tract Deposition of HFABeclomethasone and HFA-Fluticasone in Asthmatic Patients. J Aerosol Med Pulm Drug Deliv, 2016 Apr, 29(2): 127-133.

29. De Backer W et al. Lung deposition of BDP/for-moterol HFA pMDI in healthy volunteers, asthmatic, and COPD patients. J Aerosol Med Pulm Drug Deliv, 2010 Jun, 23(3): 137-148.

30. Huchon G et al. Lung function and asthma control with beclomethasone and formoterol in a single inhaler. Respir Med, 2009 Jan, 103(1): 41-49.

31. Price D et al. Real-life comparison of beclometasone dipropionate as an extrafine- or larger-particle formulation for asthma. Respir Med, 2013 Jul, 107(7): 987-1000.

32. De Backer J et al. The Effects of Extrafine Beclometasone/Formoterol (BDP/F) on Lung Function, Dyspnea, Hyperinflation, and Airway Geometry in COPD Patients: Novel Insight Using Functional Respiratory Imaging. J Aerosol Med Pulm Drug Deliv, 2015 Apr, 28(2): 88-99. doi: 10.1089/jamp.2013.1064. Epub 2014 Jul 8.

33. Mutch E et al. The role of esterases in the metabolism of ciclesonide to desisobutyrylciclesonide in human tissue. Biochem Pharmacol, 2007, 73: 1657-1666.

34. Dietzel K et al. Ciclesonide: an on-site activated steroid. Prog Respir Res, 2001, 31: 91-93.

35. Leach CL et al. Two-dimensional and three-dimensional imaging show ciclesonide has high lung deposition and peripheral distribution: a nonrandomized study in healthy volunteers. J Aerosol Med, 2006, 19: 117-126.

36. Newman S et al. High lung deposition of 99mTclabeled ciclesonide administered via HFA-MDI to patients with asthma. Respir Med, 2006, 100: 375-384.

37. Cohen J et al. Ciclesonide improves measures of small airway involvement in asthma. Eur Respir J, 2008 Jun, 31(6): 1213-1220.

38. Hoshino M et al. Comparison of effectiveness in ciclesonide and fluticasone propionate on small airway function in mild asthma. Allergology International, 2010, 59: 59-66.

39. Zietkowski Z et al. Effect of ciclesonide and fluticasone on exhaled nitric oxide in patients with mild allergic asthma. Respir Med, 2006, 100: 1651-1656.

40. Van der Molen T et al. Effectiveness of initiating extrafine-particle versus fine-particle inhaled corticosteroids as asthma therapy in the Netherlands. BMC Pulm Med, 2016 May 17, 16(1): 80.

41. Postma D et al. Asthma-Related Outcomes in Patients Initiating Extrafine Ciclesonide or Fine-Particle Inhaled Corticosteroids. Allergy Asthma Immunol Res, 2017 Mar, 9(2): 116-112.

42. Bateman ED et al. Comparison of twice-daily inhaled ciclesonide and fluticasone propionate in patients with moderate-to-severe persistent asthma. Pulm Pharmacol Ther, 2008, 21: 264-275.

43. Derom E et al. Effects of inhaled ciclesonide and fluticasone proprionate on cortisol secretion and airway responsiveness to adenosine 5’monophosphate in asthmatic patients. Pulm Pharmacol Ther, 2005, 18: 328-336.

Просмотров: 90

Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.

ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)