中性粒细胞哮喘的精确识别和靶向治疗：从分子机制到临床翻译
Precision identification and targeted therapy for neutrophilic asthma: from molecular mechanisms to clinical translation.
摘要(中文译文)
中性粒细胞性哮喘是一种独特的炎症表型，以痰中性粒细胞增多（≥61%中性粒细胞）、糖皮质激素抵抗以及较嗜酸性粒细胞性哮喘更为严重的病程为特征。本综述全面探讨了中性粒细胞性哮喘发病的分子机制，重点关注Th17/IL-17轴、中性粒细胞胞外诱捕网（NETs）及NLRP3炎症小体活化。我们提出了一个精准识别框架，将分子内型与临床表型及生物标志物谱相结合，以指导治疗决策。与嗜酸性粒细胞性哮喘不同，中性粒细胞性哮喘由于中性粒细胞凋亡受损及促炎通路的持续激活，表现出对糖皮质激素的内在抵抗。靶向IL-17、NET形成及炎症小体组分的新兴治疗方法显示出良好前景，多种药物正处于临床开发阶段。微生物组-中性粒细胞轴代表了一个新的治疗靶点，有证据表明气道菌群失调通过模式识别受体激活维持中性粒细胞性炎症。本综述为理解中性粒细胞性哮喘的发病机制提供了全面框架，并为这一难以治疗的哮喘表型勾勒了精准医学策略。
Abstract
Neutrophilic asthma represents a distinct inflammatory phenotype characterized by sputum neutrophilia (≥61% neutrophils), glucocorticoid resistance, and more severe disease course compared to eosinophilic asthma. This review comprehensively examines the molecular mechanisms underlying neutrophilic asthma pathogenesis, focusing on the Th17/IL-17 axis, neutrophil extracellular traps (NETs), and NLRP3 inflammasome activation. We present a precision identification framework integrating molecular endotypes with clinical phenotypes and biomarker profiles to guide therapeutic decisions. Unlike eosinophilic asthma, neutrophilic asthma demonstrates intrinsic resistance to glucocorticoids due to impaired neutrophil apoptosis and persistent activation of pro-inflammatory pathways. Emerging therapeutic approaches targeting IL-17, NET formation, and inflammasome components show promise, with several agents in clinical development. The microbiome-neutrophil axis represents a novel therapeutic target, with evidence suggesting that airway dysbiosis perpetuates neutrophilic inflammation through pattern recognition receptor activation. This review provides a comprehensive framework for understanding neutrophilic asthma pathogenesis and outlines precision medicine approaches for this difficult-to-treat asthma phenotype.
如何引用
AMA
Mengmeng Sun, Yan Xu, Guihua Song, Bingxue Zhang, MingHao Peng, SuPing Yu, et al. Precision identification and targeted therapy for neutrophilic asthma: from molecular mechanisms to clinical translation.. Frontiers in immunology. 2026; doi:10.3389/fimmu.2026.1878339.
APA
Mengmeng Sun, Yan Xu, Guihua Song, Bingxue Zhang, MingHao Peng, SuPing Yu, et al (2026). Precision identification and targeted therapy for neutrophilic asthma: from molecular mechanisms to clinical translation.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1878339
GB/T 7714
Mengmeng Sun, Yan Xu, Guihua Song, Bingxue Zhang, MingHao Peng, SuPing Yu, et al. Precision identification and targeted therapy for neutrophilic asthma: from molecular mechanisms to clinical translation.[J]. Frontiers in immunology, 2026 doi:10.3389/fimmu.2026.1878339.
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