Fisiopatología del asma: una mirada actual

Ricardo Durán A., MD.

Resumen


El asma es una enfermedad heterogénea y compleja en constante evolución, ahora hablamos de fenotipos moleculares que van cambiando lentamente su enfoque diagnóstico y terapéutico e identificando nuevos blancos para las herramientas farmacológicas en desarrollo.

Existen factores del huésped que predisponen a los pacientes a desarrollar la enfermedad, factores ambientales y situaciones clínicas que favorecen o agravan el asma.

Se describe la cascada inmunológica con los eventos individuales que llevan al desarrollo del asma y las características de la respuesta inmune en el asma severa además de la remodelación de la vía aérea.


Palabras clave


asma; fenotipos moleculares del asma; linfocitos TH1; linfocitos TH2; eosinófilos; asma severa; remodelación de la vía aérea

Texto completo:

PDF

Referencias


Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2015. http://www.ginasthma.org/ [Acceso 23 May 2015].

Stone KD, Prussin C, Metcalfe DD. IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol. 2010;125:S73.

Salo PM, Calatroni A, Gergen PJ, et al. Allergy-related outcomes in relation to serum IgE: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2011;127:1226.

Kaan A, Dimich-Ward H, Manfreda J, et al. Cord blood IgE: its determinants and prediction of development of asthma and other allergic disorders at 12 months. Ann Allergy Asthma Immunol.2000;84:37.

Oettgen HC, Geha RS. IgE regulation and roles in asthma pathogenesis. J Allergy Clin Immunol. 2001;107:429.

James AL, Elliot JG, Abramson MJ, Walters EH. Time to death, airway wall inflammation and remodelling in fatal asthma. Eur Respir J. 2005;26:429.

Gelb AF, Schein A, Nussbaum E, et al. Risk factors for nearfatal asthma. Chest. 2004;126:1138.

Miranda C, Busacker A, Balzar S, et al. Distinguishing severe asthma phenotypes: role of age at onset and eosinophilic inflammation. J Allergy Clin Immunol. 2004;113:101.

Von Ehrenstein OS et al: Reduced risk of hay fever and asthma among children of farmers. Clin Exp Allergy. 2000;30:187-93.

Sigurs N, Gustafsson PM, et al. Severe respiratory synsytial virus bronchiolitis in infancy and asthma and allergy at age 13. Am J Respir Crit. Care Med. 2005;171;137-41.

Jahnsen FL, Moloney ED, Hogan T, et al. Rapid dendritic cell recruitment to the bronchial mucosa of patients with atopic asthma in response to local allergen challenge. Thorax. 2001;56:823.

Wong CK, Cheung PF, Ip WK, Lam CW. Intracellular signaling mechanisms regulating toll-like receptor-mediated activation of eosinophils. Am J Respir Cell Mol Biol. 2007;37:85.

Xue L, Gyles SL, Wettey FR, et al. Prostaglandin D2 causes preferential induction of proinflammatory Th2 cytokine production through an action on chemoattractant receptor-like molecule expressed on Th2 cells. J Immunol 2005;175:6531.

Berry M, Morgan A. Shaw DE et al. Pathological features and inhaled corticosteroid response of eosinophilic and non eosinophilic asthma. Thorax 2007;62:1043-9.

Chung KF, Wenzel SE, Brozek JL, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43:343.

Moore WC, Meyers DA, Wenzel SE, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010;181:315.

Moore WC, Hastie AT, Li X, et al. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol. 2014;133:1557.

Moore WC, Hastie AT, Li X, et al. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol. 2014;133:1557.

Burgess JA, Walters EH, Byrnes GB, et al. Childhood allergic rhinitis predicts asthma incidence and persistence to middle age: a longitudinal study. J Allergy Clin Immunol. 2007;120:863.

Beuther DA, Sutherland ER. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med. 2007;175:661.

Wenzel SE, Vitari CA, Shende M, et al. Asthmatic granulomatosis: a novel disease with asthmatic and granulomatous features. Am J Respir Crit Care Med. 2012;186:501.




DOI: http://dx.doi.org/10.30789/rcneumologia.v27.n3.2015.79

Métricas de artículo

Vistas de resumen
426




Cargando métricas ...

Enlaces refback

  • No hay ningún enlace refback.


Asociación Colombiana de Neumología y Cirugía de Tórax.
Dirección: Carrera 7 Bis # 123-52 Of. 202, Teléfono: 57(1)3222335 - Bogotá - Colombia.
Sistema OJS - Metabiblioteca |