Asthma in Klinik und Praxis

Timm Greulich1, Roland Buhl2
1Klinik für Innere Medizin, Schwerpunkt Pneumologie, Universitätsklinikum Gießen und Marburg, Standort Marburg, Marburg, Deutschland
2Klinik für Pneumologie, Zentrum für Thoraxerkrankungen, Universitätsmedizin Mainz, Mainz, Deutschland

Tóm tắt

Asthma ist eine klinische Diagnose, wobei aktuelle Leitlinien ergänzend zur Beurteilung der Lungenfunktion die Berücksichtigung der Typ-2-Biomarker Eosinophile im Blut und Fraktion des exhalierten Stickstoffmonoxids („fraction of exhaled nitric oxide“, FeNO) empfehlen. Eine Phänotypisierung der Asthmaerkrankung auf Grundlage von Anamnese (u. a. Allergie), Biomarkern und Komorbiditäten ist Voraussetzung einer personalisierten Therapie. Inhalative Glukokortikoide (Inhaled corticosteroids, ICS) sind die in jeder Therapiestufe zu bevorzugende Basis der Therapie: Diese werden mit zunehmendem Asthmaschweregrad ergänzt durch lang wirksame Bronchodilatatoren und bei schwerem Asthma durch monoklonale Antikörper, die gegen Schlüsselmediatoren der asthmatischen Entzündung gerichtet sind (Biologika). Die enormen Fortschritte in der Therapie haben zu einer sehr guten Asthmakontrolle bei der sehr großen Mehrheit der Patientinnen und Patienten geführt, sodass die Asthmaerkrankung heute eine Domäne der ambulanten fachärztlichen Versorgung ist.

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