扫码登录小狗阅读
Use of endotypes, phenotypes, and inflammatory markers to guide treatment decisions in chronic rhinosinusitis.
使用内皮型、表型和炎症标志物指导慢性鼻-鼻窦炎的治疗决策。
- 影响因子:2.00
- DOI:10.1016/j.anai.2020.01.013
- 作者列表:"Staudacher AG","Peters AT","Kato A","Stevens WW
- 发表时间:2020-04-01
Abstract
OBJECTIVE:With the advent of new treatment options for Chronic Rhinosinusitis (CRS) comes the ability for physicians to provide more individualized patient care. Physicians are now tasked with identifying who may be the best candidate for a particular therapy. In this review, existing biomarkers and potentially new methods that could guide treatment choices in CRS patients will be discussed. DATA SOURCES:Published literature obtained through PubMed searches. STUDY SELECTION:Studies relevant to inflammatory endotypes, phenotypes, and biomarkers in CRS were included. RESULTS:Currently, there are no clinically validated tools that determine the best therapeutic modality for CRS patients with or without nasal polyps (CRSwNP or CRSsNP). Patients with CRS can be classified into three endotypes based on the presence of type 1, type 2, or type 3 inflammation. CRS endotypes can be influenced by age and geographic location. Clinical application however may be limited since endotyping current requires basic research laboratory support. Clinical symptoms may also predict inflammatory endotypes with smell loss being indicative of type 2 inflammation. Numbers of tissue and/or peripheral eosinophils as well as levels of IgE may predict disease severity in CRSwNP but not necessarily treatment responses. Unique clinical phenotypes or biomarkers are especially lacking that predict type 1 or type 3 inflammation in CRSwNP or type 1, type 2, or type 3 inflammation in CRSsNP. CONCLUSION:While significant progress has been made in characterizing endotypes, phenotypes, and biomarkers in CRS, additional studies are needed to determine if and how these factors could assist physicians in providing more individualized clinical care.
摘要
目的: 随着慢性鼻-鼻窦炎 (CRS) 新治疗方案的出现,医生能够提供更个体化的患者护理。医生现在的任务是确定谁可能是特定治疗的最佳候选人。在这篇综述中,将讨论现有的生物标志物和可能指导CRS患者治疗选择的新方法。 数据来源: 通过PubMed检索获得的已发表文献。 研究选择: 纳入与CRS中炎性内型、表型和生物标志物相关的研究。 结果: 目前,尚无临床验证的工具确定伴或不伴鼻息肉的CRS患者 (CRSwNP或CRSsNP) 的最佳治疗方式。根据 1 型、 2 型或 3 型炎症的存在,CRS患者可分为三种内型。CRS endotype可受年龄和地理位置的影响。然而,临床应用可能受到限制,因为内分型电流需要基础研究实验室支持。临床症状也可以预测炎性内型,嗅觉丧失提示 2 型炎症。组织和/或外周嗜酸性粒细胞的数量以及IgE水平可以预测CRSwNP的疾病严重程度,但不一定是治疗反应。尤其缺乏预测CRSwNP中 1 型或 3 型炎症或CRSsNP中 1 型、 2 型或 3 型炎症的独特临床表型或生物标志物。 结论: 虽然在表征CRS的内型、表型和生物标志物方面取得了重大进展,但还需要额外的研究来确定这些因素是否以及如何帮助医生提供更个体化的临床护理。
小狗阅读
帮助医生、学生、科研工作者解决SCI文献找不到、看不懂、阅读效率低的问题。提供领域精准的SCI文献,通过多角度解析提高文献阅读效率,从而使用户获得有价值研究思路。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.
呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。