| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 672.08 KB | Adobe PDF |
Advisor(s)
Abstract(s)
A Doença Pulmonar Obstrutiva Crónica, apesar de constituir uma patologia prevenível, é
muito comum e corresponde a uma das principais causas de morbilidade e mortalidade
em todo o mundo, assumindo-se como um importante problema de saúde pública.
Os critérios diagnósticos atuais não captam a complexidade dos diferentes fenótipos
inflamatórios que contribuem para a obstrução aérea, característica da doença.
Tradicionalmente predominam neutrófilos acompanhados de macrófagos alveolares,
linfócitos T e linfócitos B contudo, aproximadamente um terço dos pacientes com doença
estável apresenta evidências de inflamação eosinofílica, sendo também registado um
aumento no nível de eosinófilos durante exacerbações agudas em até 28% dos casos.
A procura por ferramentas diagnósticas minimamente invasivas e de fácil aplicação que
possam prever a eosinofilia nas vias aéreas tem-se intensificado, sendo que a contagem de
células no sangue periférico, um exame laboratorial simples, poderá identificar estes
pacientes.
Embora o limiar de eosinófilos associado a relevância clínica esteja atualmente sujeito a
debate, elevados níveis sanguíneos de eosinófilos foram associados ao declínio na função
pulmonar e a exacerbações mais frequentes todavia, poderão também predizer uma
resposta mais eficaz aos corticosteroides a respeito da melhoria da função pulmonar e na
prevenção e tratamento de episódios de exacerbação. Por conseguinte, as contagens de
eosinófilos parecem ter potencial como biomarcador de prognóstico e terapêutico, apesar
de mais estudos conclusivos serem ainda necessários.
Como os corticosteroides não são isentos de riscos, várias terapias biológicas direcionadas
à inflamação eosinofílica estão em desenvolvimento.
Chronic Pulmonary Obstructive Disease, though it is a preventable condition, is very common and is one of the principle causes of morbidity and mortality globally, considered a significant health problem. The current diagnostic criteria do not address the complexity of the various inflammatory phenotypes that contribute to airway obstruction, characteristic of the disease. Traditionally, neutrophils with alveolar macrophages, T lymphocytes and B lymphocytes predominate. However, approximately one third of patients with stable disease show evidence of eosinophilic inflammation, and an increase in the level of eosinophils during acute exacerbations is also reported in up to 28% of cases. The search for minimally invasive and easy-to-apply diagnostic tools that can predict eosinophilia in the airways has intensified, and the peripheral blood cell count, a simple laboratory test, can identify those patients who are affected. Although the eosinophil threshold thought to have clinical relevance is currently a matter of debate, high blood levels of eosinophils have been associated with a decline in lung function and more frequent exacerbations. However, these levels may also predict a more effective response to corticosteroids regarding improved lung function and in the prevention and treatment of episodes of exacerbation. Therefore, eosinophil counts appear to have potential as a prognostic and therapeutic biomarker, although more conclusive studies are still needed. As corticosteroids are not free of risks, several biological therapies targeting eosinophilic inflammation are under development.
Chronic Pulmonary Obstructive Disease, though it is a preventable condition, is very common and is one of the principle causes of morbidity and mortality globally, considered a significant health problem. The current diagnostic criteria do not address the complexity of the various inflammatory phenotypes that contribute to airway obstruction, characteristic of the disease. Traditionally, neutrophils with alveolar macrophages, T lymphocytes and B lymphocytes predominate. However, approximately one third of patients with stable disease show evidence of eosinophilic inflammation, and an increase in the level of eosinophils during acute exacerbations is also reported in up to 28% of cases. The search for minimally invasive and easy-to-apply diagnostic tools that can predict eosinophilia in the airways has intensified, and the peripheral blood cell count, a simple laboratory test, can identify those patients who are affected. Although the eosinophil threshold thought to have clinical relevance is currently a matter of debate, high blood levels of eosinophils have been associated with a decline in lung function and more frequent exacerbations. However, these levels may also predict a more effective response to corticosteroids regarding improved lung function and in the prevention and treatment of episodes of exacerbation. Therefore, eosinophil counts appear to have potential as a prognostic and therapeutic biomarker, although more conclusive studies are still needed. As corticosteroids are not free of risks, several biological therapies targeting eosinophilic inflammation are under development.
Description
Keywords
Corticosteroides Dpoc Eosinófilos Exacerbações Marcador Terapêutico