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首页> 外文期刊>Journal of International Medical Research >Severe pediatric asthma with a poor response to omalizumab: a report of three cases and three-dimensional bronchial wall analysis
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Severe pediatric asthma with a poor response to omalizumab: a report of three cases and three-dimensional bronchial wall analysis

机译：严重的儿科哮喘对omalizumab的反应不佳：三种病例报告和三维支气管壁分析

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摘要

Omalizumab is used for the treatment of persistent severe allergic asthma in adults and children. However, some patients remain symptomatic even after omalizumab treatment. In bronchial asthma, chronic inflammation of the bronchial wall causes thickening of the airway wall, resulting from irreversible airway remodeling. Progression of airway remodeling causes airflow obstruction, leading to treatment resistance. We report three Japanese children with severe asthma who had a poor response to omalizumab treatment. They had a long period of inadequate management of asthma before initiating omalizumab. Even after omalizumab treatment, their symptoms persisted, and the parameters of spirometry tests did not improve. We hypothesized that omalizumab was less effective in these patients because airway wall remodeling had already progressed. We retrospectively evaluated the bronchial wall thickness using a three-dimensional bronchial wall analysis with chest computed tomography. The bronchial wall thickness was increased in these cases compared with six responders. Progressed airway wall thickness caused by airway remodeling may be associated with a poor response to omalizumab in children with severe asthma.
机译：omalizumab用于治疗成人和儿童持续严重过敏性哮喘。然而，即使在omalizumab治疗后，一些患者仍然存在症状。在支气管哮喘中，支气管壁的慢性炎症导致气道壁的增厚，由不可逆的气道重塑引起。气道重塑的进展导致气流阻塞，导致治疗抵抗力。我们报告了三个具有较严重的哮喘的日本儿童，对奥马拉姆采购治疗不佳。在发起omalizumab之前，它们在哮喘的哮喘管理中长期以来。即使在omalizumab治疗后，它们的症状持续存在，血液测量术试验的参数并未改善。我们假设omalizumab在这些患者中对这些患者的效果较小，因为气道墙体重塑已经进行了进展。我们回顾性地使用胸部计算断层扫描的三维支气管壁分析评估支气管壁厚。与六个响应者相比，在这些情况下，支气管壁厚增加。通过气道重塑引起的呼吸道壁厚度可能与严重哮喘患儿对奥纳利珠宝的反应不良。

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