山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (5): 28-34.doi: 10.6040/j.issn.1671-7554.0.2024.0186
• 慢性气道疾病的精准个体化诊疗——专家综述 • 上一篇
王婷1,2,3,张丽4,王刚1,2,3
WANG Ting1,2,3, ZHANG Li4, WANG Gang1,2,3
摘要: 支气管哮喘(简称哮喘)是常见的慢性气道炎症疾病,存在明显的异质性。应用多维度评估识别哮喘的可治疗特质,可望提高哮喘控制并实现临床缓解。以焦虑、抑郁等为主要表现的神经心理功能异常是哮喘肺外可治疗特质评估的重要内容。合并焦虑和/或抑郁可恶化哮喘症状,降低生活质量,增加急性发作,因此神经心理性哮喘作为一特殊哮喘表型而备受关注。本文对神经心理性哮喘的临床流行病学、神经心理因素对哮喘的影响、神经心理性哮喘发生机制以及评估和治疗手段进行述评,为神经心理性哮喘未来的研究和管理提供参考。
中图分类号:
[1] GBD Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1204-1222. [2] Huang KW, Yang T, Xu JY, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study[J]. Lancet, 2019, 394(10196): 407-418. [3] Menzies-Gow A, Bafadhel M, Busse WW, et al. An expert consensus framework for asthma remission as a treatment goal[J]. J Allergy Clin Immunol, 2020, 145(3): 757-765. [4] McDonald VM, Hiles SA, Godbout K, et al. Treatable traits can be identified in a severe asthma registry and predict future exacerbations[J]. Respirology, 2019, 24(1): 37-47. [5] Wu WW, Zhang X, Li M, et al. Treatable traits in elderly asthmatics from the Australasian severe asthma network: a prospective cohort study[J]. J Allergy Clin Immunol Pract, 2021, 9(7): 2770-2782. [6] Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma[J]. Eur Respir J, 2014, 43(2): 343-373. [7] Wang G, McDonald VM, Gibson PG. Management of severe asthma: from stepwise approach to therapy to treatable traits?[J]. Precis Clin Med, 2021, 4(4): 293-296. [8] Wang G, McDonald VM. Contemporary concise review 2020: asthma[J]. Respirology, 2021, 26(8): 804-811. [9] Wu WW, Zhang X, Li M, et al. Treatable traits in elderly asthmatics from the Australasian severe asthma network: a prospective cohort study[J]. J Allergy Clin Immunol Pract, 2021, 9(7): 2770-2782. [10] Zhang Q, Wu WW, Li L, et al. Workup of difficult-to-treat asthma: implications from treatable traits[J]. Precis Clin Med, 2023, 6(1): pbad003. doi:10.1093/pcmedi/pbad003. [11] Zhang L, Zhang X, Zheng J, et al. Depressive symptom-associated IL-1β and TNF-α release correlates with impaired bronchodilator response and neutrophilic airway inflammation in asthma[J]. Clin Exp Allergy, 2019, 49(6): 770-780. [12] Scott KM, von Korff M, Ormel J, et al. Mental disorders among adults with asthma: results from the World Mental Health Survey[J]. Gen Hosp Psychiatry, 2007, 29(2): 123-133. [13] Shaw DE, Sousa AR, Fowler SJ, et al. Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort[J]. Eur Respir J, 2015, 46(5): 1308-1321. [14] Hou RH, Ye G, Cheng XJ, et al. The role of inflammation in anxiety and depression in the European U-BIOPRED asthma cohorts[J]. Brain Behav Immun, 2023, 111: 249-258. doi:10.1016/j.bbi.2023.04.011. [15] Luyster FS, Strollo PJ Jr, Holguin F, et al. Association between insomnia and asthma burden in the severe asthma research program(SARP)III[J]. Chest, 2016, 150(6): 1242-1250. [16] van de Loo KF, van Gelder MM, Roukema J, et al. Prenatal maternal psychological stress and childhood asthma and wheezing: a meta-analysis[J]. Eur Respir J, 2016, 47(1): 133-146. [17] Lavoie KL, Bacon SL, Barone S, et al. What is worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both?[J]. Chest, 2006, 130(4): 1039-1047. [18] Lavoie KL, Cartier A, Labrecque M, et al. Are psychiatric disorders associated with worse asthma control and quality of life in asthma patients?[J]. Respir Med, 2005, 99(10): 1249-1257. [19] Li HL, He XL, Liang BM, et al. Anxiety but not depression symptoms are associated with greater perceived dyspnea in asthma during bronchoconstriction[J]. Allergy Asthma Proc, 2015, 36(6): 447-457. [20] Wang L, Liang R, Zhou T, et al. Identification and validation of asthma phenotypes in Chinese population using cluster analysis[J]. Ann Allergy Asthma Immunol, 2017, 119(4): 324-332. [21] Zhang L, Zhang X, Zheng J, et al. Co-morbid psychological dysfunction is associated with a higher risk of asthma exacerbations: a systematic review and meta-analysis[J]. J Thorac Dis, 2016, 8(6): 1257-1268. [22] Davis JB. Neurotic illness in the families of children with asthma and wheezy bronchitis: a general practice population study[J]. Psychol Med, 1977, 7(2): 305-310. [23] Zhu ZZ, Zhu X, Liu CL, et al. Shared genetics of asthma and mental health disorders: a large-scale genome-wide cross-trait analysis[J]. Eur Respir J, 2019, 54(6): 1901507. doi:10.1183/13993003.01507-2019. [24] Lehto K, Pedersen NL, Almqvist C, et al. Asthma and affective traits in adults: a genetically informative study[J]. Eur Respir J, 2019, 53(5): 1802142. doi:10.1183/13993003.02142-2018. [25] Carlson SM, Kim J, Khan DA, et al. Hippocampal volume in patients with asthma: results from the Dallas Heart Study[J]. J Asthma, 2017, 54(1): 9-16. [26] Kroll JL, Ritz T. Asthma, the central nervous system, and neurocognition: current findings, potential mechanisms, and treatment implications[J]. Neurosci Biobehav Rev, 2023, 146: 105063. doi:10.1016/j.neubiorev.2023.105063. [27] von Leupoldt A, Sommer T, Kegat S, et al. Down-regulation of insular cortex responses to dyspnea and pain in asthma[J]. Am J Respir Crit Care Med, 2009, 180(3): 232-238. [28] Dill-McFarland KA, Altman MC, Esnault S, et al. Molecular pathways underlying lung-brain axis signaling in asthma: relevance for psychopathology and neuroinflammation[J]. J Allergy Clin Immunol, 2024, 153(1): 111-121. [29] Zhu M, Liang ZA, Wang T, et al. Th1/Th2/Th17 cells imbalance in patients with asthma with and without psychological symptoms[J]. Allergy Asthma Proc, 2016, 37(2): 148-156. [30] Miller AH, Raison CL. The role of inflammation in depression: from evolutionary imperative to modern treatment target[J]. Nat Rev Immunol, 2016, 16(1): 22-34. [31] He LX, Deng K, Wang J, et al. Clinical subtypes of neutrophilic asthma: a cluster analysis from Australasian severe asthma network[J]. J Allergy Clin Immunol Pract, 2024, 12(3): 686-698.e8. [32] Deng K, Zhang X, Liu Y, et al. Heterogeneity of paucigranulocytic asthma: a prospective cohort study with hierarchical cluster analysis[J]. J Allergy Clin Immunol Pract, 2021, 9(6): 2344-2355. [33] Khandaker GM, Pearson RM, Zammit S, et al. Association of serum interleukin 6 and C-reactive protein in childhood with depression and psychosis in young adult life: a population-based longitudinal study[J]. JAMA Psychiatry, 2014, 71(10): 1121-1128. [34] Iwata M, Ota KT, Duman RS. The inflammasome: pathways linking psychological stress, depression, and systemic illnesses[J]. Brain Behav Immun, 2013, 31: 105-114. doi:10.1016/j.bbi.2012.12.008. [35] Bjelland I, Dahl AA, Haug TT, et al. The validity of the Hospital Anxiety and Depression Scale. An updated literature review[J]. J Psychosom Res, 2002, 52(2): 69-77. [36] Brown ES, Sayed N, van Enkevort E, et al. A randomized, double-blind, placebo-controlled trial of escitalopram in patients with asthma and major depressive disorder[J]. J Allergy Clin Immunol Pract, 2018, 6(5): 1604-1612. [37] Brown ES, Howard C, Khan DA, et al. Escitalopram for severe asthma and major depressive disorder: a randomized, double-blind, placebo-controlled proof-of-concept study[J]. Psychosomatics, 2012, 53(1): 75-80. [38] Brown ES, Vigil L, Khan DA, et al. A randomized trial of citalopram versus placebo in outpatients with asthma and major depressive disorder: a proof of concept study[J]. Biol Psychiatry, 2005, 58(11): 865-870. [39] Nagayasu K, Kitaichi M, Nishitani N, et al. Chronic effects of antidepressants on serotonin release in rat raphe slice cultures: high potency of milnacipran in the augmentation of serotonin release[J]. Int J Neuropsychopharmacol, 2013, 16(10): 2295-2306. [40] Mendez-Enriquez E, Alvarado-Vazquez PA, Abma W, et al. Mast cell-derived serotonin enhances methacholine-induced airway hyperresponsiveness in house dust mite-induced experimental asthma[J]. Allergy, 2021, 76(7): 2057-2069. [41] Yorke J, Fleming SL, Shuldham CM. Psychological interventions for adults with asthma[J]. Cochrane Database Syst Rev, 2006, 2006(1): CD002982. doi:10.1002/14651858.CD002982.pub3. [42] Sharrad KJ, Sanwo O, Cuevas-Asturias S, et al. Psychological interventions for asthma in children and adolescents[J]. Cochrane Database Syst Rev, 2024, 1(1): CD013420. doi:10.1002/14651858.CD013420.pub2. [43] Meuret AE, Rosenfield D, Millard MM, et al. Biofeedback training to increase P CO2 in asthma with elevated anxiety: a one-stop treatment of both conditions?[J]. Psychosom Med, 2023, 85(5): 440-448. [44] Gephine S, Fry S, Margoline E, et al. Home-based pulmonary rehabilitation for adults with severe asthma exposed to psychosocial chronic stressors[J]. Respir Med, 2023, 217: 107349. doi:10.1016/j.rmed.2023.107349. [45] McDonald VM, Hamada Y, Agusti A, et al. Treatable traits in asthma: the importance of extrapulmonary traits-GERD, CRSwNP, atopic dermatitis, and depression/anxiety[J]. J Allergy Clin Immunol Pract, 2024, 12(4): 824-837. [46] Thomas D, McDonald VM, Stevens S, et al. Biologics(mepolizumab and omalizumab)induced remission in severe asthma patients[J]. Allergy, 2024, 79(2): 384-392. [47] Masefield S, Edwards J, Hansen K, et al. The future of asthma research and development: a roadmap from the European Asthma Research and Innovation Partnership(EARIP)[J]. Eur Respir J, 2017, 49(5): 1602295. doi:10.1183/13993003.02295-2016. |
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