摘要
慢性阻塞性肺疾病(简称慢阻肺)是我国重点防治的慢性呼吸系统疾病之一,深入探讨慢阻肺的免疫发病机制并对其中的关键靶点进行干预可能为慢阻肺的防治提供新办法。基于目前临床常用的慢阻肺免疫调节剂相关研究证据及具有免疫治疗作用的药物研发现状和趋势,《慢性阻塞性肺疾病免疫调节治疗专家共识》撰写组提出4条推荐意见:(1)细菌溶解产物、磷酸二酯酶抑制剂、大环内酯类药物等生物、化学制剂均可通过增强机体免疫功能和提高免疫细胞活性而发挥对慢阻肺的免疫调节作用;(2)针对流感病毒、肺炎球菌感染等进行疫苗接种可预防慢阻肺急性加重、降低患者死亡率;(3)他汀类药物及维生素D等具有免疫调节作用,对慢阻肺可能有一定的治疗作用,但二者在慢阻肺中的应用证据较少且存在一定不良反应,仍需进一步积累证据;(4)中医药复方及虫草制剂或可通过调节机体免疫功能、提高免疫细胞活性改善慢阻肺稳定期患者生活质量,减少急性加重。本专家共识旨在进一步推动我国慢阻肺免疫调节治疗的临床实践。
China has attached importance to the prevention and treatment of chronic obstructive pulmonary disease(COPD),a major chronic respiratory disease.An in-depth discussion of the immunopathogenesis of COPD and intervening the identified key targets may be new ideas for the prevention and treatment of COPD.Based on the relevant evidence of commonly used immunomodulatory agents for COPD,and the status and trend of development of immunomodulators for COPD,the Writing Group for the Expert Consensus of Immunemodulatory Therapies for Chronic Obstructive Pulmonary Disease proposed the following four recommendations for treating COPD with immunomodulatory therapies:(1)bacterial lysates,phosphodiesterase inhibitors,macrolides and other biological and chemical agents have immunomodulatory efects on COPD by enhancing immune function and immune cell activity;(2)vaccination against influenza and pneumococcal infection could reduce the probability of acute exacerbation of COPD and mortality;(3)statins and vitamin D may be partially effective in COPD owing to their immunomodulatory actions,but need to be verified further due to quite insufficient relevant evidence and reported adverse reactions;(4)Chinese medicine compound and Cordyceps preparations may improve the quality of life and reduce the probability of acute exacerbationsin patients with stable COPD by regulating immune function and improving immune cell activity.The main purpose of this consensus is to greatly promote the clinical treatment of COPD using immunomodulatory therapies in China.
出处
《中国全科医学》
CAS
北大核心
2022年第24期2947-2959,共13页
Chinese General Practice
基金
国家自然科学基金资助项目(82090013,82090014)
首都卫生发展科研专项项目(首发2020-2Z-40917)。
关键词
肺疾病
慢性阻塞性
慢性阻塞性肺疾病
免疫调节
药理作用分子作用机制
专家共识
Pulmonary disease,chronic obstructive
Chronic obstructive pulmonary disease
Immunomodulation
Molecular mechanisms of pharmacological action
Expert consensus
