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Evaluating Vonoprazan for the treatment of erosive GERD and heartburn associated with GERD in adults. 评估 Vonoprazan 治疗成人侵蚀性胃食管反流病和胃食管反流病相关烧心症状的效果。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-06 DOI: 10.1080/14656566.2024.2427335
Elisa Marabotto, Francesco Calabrese, Andrea Pasta, Pierfrancesco Visaggi, Nicola de Bortoli, Amir Mari, Salvatore Tolone, Matteo Ghisa, Luisa Bertin, Vincenzo Savarino, Edoardo Vincenzo Savarino

Introduction: Gastroesophageal reflux disease (GERD) is a common debilitating chronic disease presenting in two main forms based on esophageal mucosal appearance, the erosive reflux disease (ERD) and the non-erosive reflux disease (NERD). Acid secretion is a key factor in the disease pathogenesis and management. Potent acid-suppressant drugs have been manufactured since the mid of 1970s, initially with histamine-H2-receptors antagonists, and later, inhibitors of the proton pump (H+-K+-ATPase). More recently, potassium-competitive acid blockers (P-CABs), particularly Vonoprazan, have been introduced. Vonoprazan has shown high efficacy and safety profiles and exhibits several advantages that allow to overcome shortcomings of proton pump inhibitors (PPIs).

Areas covered: In this review, we provide an updated summary of Vonoprazan pharmacodynamics and its role in clinical practice for the management of erosive esophagitis and GERD related heartburn. Moreover, we discuss characteristics of Vonoprazan that allow to bypass some limitations of the older PPIs.

Expert opinion: Long-term safety and efficacy of Vonoprazan have already been demonstrated for the induction and maintenance of ERD, preventing nocturnal acid breakthrough, reducing reflux symptoms in non-responder to standard therapy. Ongoing and future studies are expected to further elucidate its long-term benefits and potential applications in other acid-related disorders.

简介胃食管反流病(GERD)是一种常见的使人衰弱的慢性疾病,根据食管粘膜外观可分为两种主要形式:侵蚀性反流病(ERD)和非侵蚀性反流病(NERD)。酸分泌是疾病发病机制和治疗的关键因素。自 20 世纪 70 年代中期以来,人们开始制造强效抑酸药物,最初是组胺-H2 受体拮抗剂,后来是质子泵(H+-K+-ATP 酶)抑制剂。最近,又出现了钾竞争性酸阻滞剂(P-CABs),特别是沃诺普拉赞。沃诺普拉赞显示出很高的疗效和安全性,并具有克服质子泵抑制剂(PPIs)缺点的若干优势:在这篇综述中,我们对沃诺普拉赞的药效学及其在治疗侵蚀性食管炎和胃食管反流相关烧心症状的临床实践中的作用进行了最新总结。此外,我们还讨论了Vonoprazan的一些特点,这些特点使其能够绕过老式PPIs的一些局限性:Vonoprazan在诱导和维持ERD、防止夜间胃酸突破、减轻标准疗法无效者的反流症状方面的长期安全性和有效性已经得到证实。正在进行的研究和未来的研究有望进一步阐明其长期疗效以及在其他酸相关疾病中的潜在应用。
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引用次数: 0
Metabolic-associated steatotic liver disease and hepatocellular carcinoma. 代谢相关性脂肪肝和肝细胞癌。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-06 DOI: 10.1080/14656566.2024.2426680
Giovanni Catalano, Odysseas P Chatzipanagiotou, Jun Kawashima, Timothy M Pawlik

Introduction: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) has been introduced as a superior term to describe steatosis on a background of metabolic dysregulation and is slated to become the leading cause of HCC worldwide, as the incidence of metabolic comorbidities is increasing. As such, MASLD has evolved into an important public health issue, potentially leading to higher rates of liver mortality and end-stage liver disease. To this end, understanding the association between MASLD and HCC may allow for the identification of better interventions and novel therapeutic strategies.

Areas covered: The authors provide a review of current knowledge on HCC development among patients with MASLD, with insights into molecular pathways and current and future therapeutic strategies.

Expert opinion: MASLD has a strong association with the risk of HCC development, as metabolic comorbidities induce dysregulation in molecular pathways, leading to insulin-resistance, oxidative stress, and chronic inflammation, thus causing progression to cirrhosis and eventually to HCC. Therapeutic strategies focused on reducing diabetes-associated complications, as well as the prevalence of obesity and smoking can improve patient outcomes and reduce HCC incidence. Future studies on the molecular background of metabolic alterations may help devise new therapeutic approaches aiming to improve the current management of MASLD-HCC.

导言:代谢功能障碍相关性脂肪性肝病(MASLD)是描述在代谢失调背景下出现的脂肪性肝病的高级术语,随着代谢合并症发病率的增加,MASLD 将成为全球导致 HCC 的主要原因。因此,MASLD 已发展成为一个重要的公共卫生问题,有可能导致更高的肝脏死亡率和终末期肝病。为此,了解 MASLD 与 HCC 之间的关联可能有助于确定更好的干预措施和新型治疗策略:作者综述了目前关于MASLD患者发生HCC的知识,深入探讨了分子途径以及当前和未来的治疗策略:MASLD与HCC发病风险密切相关,因为代谢合并症会诱发分子通路失调,导致胰岛素抵抗、氧化应激和慢性炎症,从而引起肝硬化进展,最终导致HCC。以减少糖尿病相关并发症以及肥胖和吸烟率为重点的治疗策略可以改善患者的预后并降低 HCC 发病率。未来对代谢改变分子背景的研究可能有助于设计新的治疗方法,从而改善目前对 MASLD-HCC 的管理。
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引用次数: 0
Reassessing the role of aspirin in patients with coronary artery disease. 重新评估阿司匹林在冠心病患者中的作用。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-06 DOI: 10.1080/14656566.2024.2427338
Udaya S Tantry, Richard C Becker, Sahib Singh, Lekshminarayan Raghavakurup, Eliano Navarese, Kevin P Bliden, Paul A Gurbel

Introduction: Recent data question the use of aspirin as a bedrock of antiplatelet therapy in patients with arterial diseases. There are controversies regarding the efficacy of aspirin therapy with respect to specific demographic characteristics, dose and formulations, benefit in primary prevention, and duration in secondary prevention. Importantly, to balance the ischemic benefits and the risk of excessive bleeding following a coronary event, recent studies have investigated strategies to discontinue aspirin therapy and continue with P2Y12 receptor inhibitor monotherapy. But the precise time when to discontinue aspirin is still unresolved.

Areas covered: Evidence from recent studies evaluating the role of aspirin in primary and secondary prevention studies were collected from a selective literature search. In this review, the authors discuss current recommendations, large scale studies of aspirin therapy, controversies, and potential future opportunities for aspirin therapy.

Expert opinion: With the new evidence showing lower bleeding risk with aspirin free strategies in both primary and secondary prevention studies, the role of aspirin is being revaluated with P2Y12 receptor inhibitor monotherapy. The potential benefit of novel aspirin formulations and alternative delivery methods, such as inhaled aspirin, are undergoing much needed investigation with the goal of optimizing care for a wide range of patients.

导言:最近的数据对阿司匹林作为动脉疾病患者抗血小板疗法的基础提出了质疑。关于阿司匹林治疗在特定人群特征、剂量和配方、一级预防中的益处以及二级预防中的持续时间等方面的疗效存在争议。重要的是,为了平衡冠状动脉事件后的缺血性获益和过度出血风险,最近的研究探讨了停止阿司匹林治疗并继续使用 P2Y12 受体抑制剂单药治疗的策略。但何时停用阿司匹林的确切时间仍悬而未决:通过选择性文献检索,收集了近期评估阿司匹林在一级和二级预防研究中作用的研究证据。在这篇综述中,作者讨论了当前的建议、阿司匹林治疗的大规模研究、争议以及阿司匹林治疗未来的潜在机会:专家观点:有新证据显示,在一级和二级预防研究中,不使用阿司匹林的策略可降低出血风险,因此阿司匹林与 P2Y12 受体抑制剂单药治疗的作用正在被重新评估。目前正在对新型阿司匹林制剂和替代给药方法(如吸入式阿司匹林)的潜在益处进行亟需的研究,以优化对各类患者的治疗。
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引用次数: 0
Pharmacotherapeutic strategies for the treatment of anorexia nervosa - novel targets to break a vicious cycle. 治疗神经性厌食症的药物治疗策略--打破恶性循环的新目标。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-05 DOI: 10.1080/14656566.2024.2424316
Millie C Kirchberg, Claire Pinson, Guido K W Frank

Introduction: Anorexia nervosa (AN) has one of the highest mortality rates of all mental illnesses. No approved pharmacological treatments exist for AN, but novel neurobiological targets show promise.

Areas covered: Studies show that in individuals with AN, there are alterations in brain neurotransmitter signaling, alongside associated mental rigidity and comorbid anxiety and depression. Available and new therapies could be used to improve alterations in neurobiology and behavior. This narrative review serves as a review of previously published literature assessing the efficacy of traditional pharmacotherapy in treating AN while also exploring novel treatments, including dissociative anesthetics, psychedelics, cannabinoids, hormones, neurosteroids, and ketogenic nutrition.

Expert opinion: If best practice psychotherapeutic interventions have failed, we recommend a neuroscience and brain research-based medication approach that targets dopamine neurotransmitter receptors to enhance cognitive flexibility and illness insight while reducing dread and avoidance toward food. It is furthermore essential to recognize and treat comorbid conditions such as anxiety, depression, or obsessive-compulsive disorder as they interfere with recovery, and typically do not resolve even with successful AN treatment. Novel strategies have the promise to show efficacy in improving mood and reducing specific AN psychopathology with hopes to be used in clinical practice soon.

简介神经性厌食症(AN)是死亡率最高的精神疾病之一。目前尚无针对神经性厌食症的经批准的药物治疗方法,但新的神经生物学靶点显示出治疗前景:研究表明,神经性厌食症患者的大脑神经递质信号发生改变,同时伴有精神僵化、合并焦虑和抑郁。现有疗法和新疗法可用于改善神经生物学和行为学的改变。这篇叙述性综述回顾了之前发表的文献,评估了传统药物疗法治疗自闭症的疗效,同时还探讨了新型疗法,包括解离性麻醉剂、迷幻剂、大麻素、激素、神经类固醇和生酮营养:如果最佳心理治疗干预无效,我们建议采用以神经科学和脑科学研究为基础的药物治疗方法,以多巴胺神经递质受体为靶点,增强认知灵活性和疾病洞察力,同时减少对食物的恐惧和回避。此外,认识并治疗焦虑症、抑郁症或强迫症等合并症也很重要,因为这些疾病会影响患者的康复,而且即使成功治疗了自闭症,这些疾病通常也不会消失。新策略有望在改善情绪和减少特定 AN 精神病理学方面显示出疗效,并有望很快应用于临床实践。
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引用次数: 0
Pharmacotherapeutic strategies for the management of erectile dysfunction in patients with diabetes and pre-diabetes. 糖尿病和糖尿病前期患者勃起功能障碍的药物治疗策略。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-11-05 DOI: 10.1080/14656566.2024.2422547
Giovanni Corona, Giulia Rastrelli, Clotilde Sparano, Linda Vignozzi, Alessandra Sforza, Mario Maggi

Introduction: Erectile dysfunction (ED) is a neglected complication in patients with pre-diabetes or diabetes mellitus (DM).

Areas covered: A summary and review of the role of standard ED treatment and the contribution of lifestyle modification and hypoglycemic drugs.

Expert opinion: Oral phosphodiesterase type 5 inhibitors (PDE5i) represent the first-line therapy even in patients with DM. Testosterone replacement therapy (TRT) is mandatory in all hypogonadal (total testosterone < 12 nmol/l) subjects. Alprostadil and/or combined approaches can be considered when PED5i with or without TRT fail. The glycometabolic optimization through lifestyle modification and the use of hypoglycemic drugs represents a crucial step, even for ED treatment. Considering the strong association between ED and forthcoming cardiovascular diseases, the selection of glucagon-like peptide type 1 analogues or sodium glucose cotransporter-2 inhibitors seems to represent the best option due to their long-term effect on chronic complication prevention. Metformin can be considered a possible alternative in less complicated subjects. Penile prostheses (PP) can be offered when all other options are not effective, but the patients should be informed that poor glycometabolic control can increase the risk of PP infection.

简介:勃起功能障碍(ED)是糖尿病前期或糖尿病(DM)患者的一种被忽视的并发症:专家意见:口服5型磷酸二酯酶抑制剂(PDE5i)是即使是DM患者的一线疗法。睾酮替代疗法(TRT)是所有性腺功能减退症患者(总睾酮水平低于50%)必须接受的治疗方法。
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引用次数: 0
Current and emerging treatment modalities for fibrodysplasia ossificans progressiva. 纤维增生性骨质疏松症的现有和新兴治疗模式。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-28 DOI: 10.1080/14656566.2024.2422548
Dilan Gençel, Nejla Nur Erbil, Şeniz Demiryürek, Abdullah Tuncay Demiryürek

Introduction: Heterotopic ossification (HO), acquired or hereditary, is a diverse pathological condition defined by the production of extraskeletal bone in muscles, soft tissues, and connective tissues. Acquired HO is relatively prevalent and develops mostly in response to trauma, although its etiology is unknown. Genetic forms provide insight into the pathobiological mechanisms of this disorder. Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary form of HO that can have a significant impact on affected individuals. FOP steadily weakens affected subjects and increases their risk of death.

Areas covered: The U.S. Food and Drug Administration has recently approved the retinoid palovarotene as the first compound to treat heterotopic ossification in patients with FOP. This review provides a comprehensive overview of current and potential future pharmacotherapeutic options and their modes of action. The online databases PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched using the terms 'heterotopic ossification' and 'fibrodysplasia ossificans progressiva' or synonyms, with a special focus over the last 5 years of publications.

Expert opinion: Approval of palovarotene, as the first retinoid indicated for reduction in the volume of new HO, may revolutionize the therapeutic landscape. However, long-term safety and efficacy data for palovarotene are currently lacking.

导言:异位骨化(HO),无论是获得性还是遗传性的,都是一种在肌肉、软组织和结缔组织中产生骨外骨的多种病理状态。获得性异位骨化(HO)的发病率相对较高,主要是由于创伤引起的,但其病因尚不清楚。遗传形式使人们对这种疾病的病理生物学机制有了更深入的了解。纤维增生性骨质疏松症(FOP)是一种罕见的遗传性骨质疏松症,会对患者产生重大影响。FOP 会逐渐削弱患者的体质,增加其死亡风险:美国食品和药物管理局最近批准了视黄醇类药物帕洛伐汀,作为治疗 FOP 患者异位骨化的首个化合物。本综述全面概述了当前和未来潜在的药物治疗方案及其作用模式。我们使用 "异位骨化 "和 "渐进性骨化性纤维增生症 "或同义词在PubMed、Cochrane Library、Web of Science和ClinicalTrials.gov等在线数据库中进行了检索,并特别关注了最近5年的出版物:帕罗瓦罗汀是第一种用于减少新发HO体积的维甲酸类药物,它的批准可能会彻底改变治疗格局。然而,目前尚缺乏帕洛伐汀的长期安全性和有效性数据。
{"title":"Current and emerging treatment modalities for fibrodysplasia ossificans progressiva.","authors":"Dilan Gençel, Nejla Nur Erbil, Şeniz Demiryürek, Abdullah Tuncay Demiryürek","doi":"10.1080/14656566.2024.2422548","DOIUrl":"10.1080/14656566.2024.2422548","url":null,"abstract":"<p><strong>Introduction: </strong>Heterotopic ossification (HO), acquired or hereditary, is a diverse pathological condition defined by the production of extraskeletal bone in muscles, soft tissues, and connective tissues. Acquired HO is relatively prevalent and develops mostly in response to trauma, although its etiology is unknown. Genetic forms provide insight into the pathobiological mechanisms of this disorder. Fibrodysplasia ossificans progressiva (FOP) is a rare hereditary form of HO that can have a significant impact on affected individuals. FOP steadily weakens affected subjects and increases their risk of death.</p><p><strong>Areas covered: </strong>The U.S. Food and Drug Administration has recently approved the retinoid palovarotene as the first compound to treat heterotopic ossification in patients with FOP. This review provides a comprehensive overview of current and potential future pharmacotherapeutic options and their modes of action. The online databases PubMed, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched using the terms 'heterotopic ossification' and 'fibrodysplasia ossificans progressiva' or synonyms, with a special focus over the last 5 years of publications.</p><p><strong>Expert opinion: </strong>Approval of palovarotene, as the first retinoid indicated for reduction in the volume of new HO, may revolutionize the therapeutic landscape. However, long-term safety and efficacy data for palovarotene are currently lacking.</p>","PeriodicalId":12184,"journal":{"name":"Expert Opinion on Pharmacotherapy","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating recent advances in pharmacotherapy for acute and chronic ocular pain post-cataract surgery. 研究白内障手术后急慢性眼痛药物疗法的最新进展。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-28 DOI: 10.1080/14656566.2024.2421323
Pragnya R Donthineni, Wade Munger, Anat Galor
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引用次数: 0
Pharmacological management of heart failure: a patient-centered approach. 心力衰竭的药物治疗:以患者为中心的方法。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-22 DOI: 10.1080/14656566.2024.2418414
Guglielmo Fibbi, Ryosuke Sato, Mirela Vatic, Frederik Pascal Genreith, Stephan von Haehling

Introduction: Heart failure (HF) is a global health challenge that requires a multidisciplinary approach. Despite recent advances in pharmacological and interventional therapy, morbidity and mortality in these patients remain high. For this reason, and because of its interplay with other cardiovascular and non-cardiovascular diseases, HF represents a major area of research, with new trials being published every year and international guidelines constantly updated.

Areas covered: The authors review the current status and possible future developments in HF pharmacotherapy.

Expert opinion: The treatment of HF has made significant advances in recent years, and the current recommendations are based on large outcome trials. This has led to significant reductions in both mortality and morbidity, but the death rate remains unacceptably high. In this context, a patient-centered approach that considers comorbidities and specific clinical scenarios when dosing HF medication is essential. Prevention of hospital admissions for cardiac decompensation is of utmost importance in patients with HF as is the enablement of activities of daily living, an endpoint which has only recently been incorporated into major HF trials.

导言心力衰竭(HF)是一项全球性的健康挑战,需要采用多学科方法进行治疗。尽管最近在药物治疗和介入治疗方面取得了进展,但这些患者的发病率和死亡率仍然居高不下。由于这一原因,并由于其与其他心血管和非心血管疾病的相互作用,心力衰竭是一个重要的研究领域,每年都有新的试验发表,国际指南也在不断更新:作者回顾了心房颤动药物治疗的现状和未来可能的发展:专家观点:近年来,心房颤动的治疗取得了重大进展,目前的建议均以大型结果试验为基础。这使得死亡率和发病率均大幅下降,但死亡率仍然高得令人无法接受。在这种情况下,必须采取以患者为中心的方法,在使用高血压药物时考虑到合并症和特定的临床情况。对于心房颤动患者来说,预防因心脏失代偿而入院至关重要,同样重要的是使患者能够进行日常生活活动,而这一终点直到最近才被纳入主要的心房颤动试验中。
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引用次数: 0
Current and emerging opioids for the treatment of chronic cough: a mini review. 用于治疗慢性咳嗽的现有和新兴阿片类药物:微型综述。
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-22 DOI: 10.1080/14656566.2024.2418983
Mengru Zhang, Alyn H Morice

Introduction: Chronic cough has increasingly been recognized as a distinct clinical entity that affects a significant portion of the global population. Despite advancements in understanding its pathophysiology, treatment options remain limited. Opioid analgesics have long been used for cough and some have proven clear antitussive potential. However, these have yet to be approved by regulatory authorities for the treatment of chronic cough. Several novel synthetic opioid modulators that demonstrated antitussive effects in early-stage studies also failed to translate into clinical practice.

Areas covered: This mini review aims to summarize the implications of opioid receptors in the development of cough medicines and highlight recent advances of opioid analgesics in cough trials. PUB MED/CINAHL/Web of Science/Scopus were searched (September 2024).

Expert opinion: Our understanding of the precise sites of action and the involvement of peripheral opioid receptors in cough remains limited. Despite these gaps in knowledge, opioids remain a viable option for some patients until more novel effective treatments are available. Due to the frequent opioid side effects, new opioids derivatives with improved properties are needed. The development of tailored or biased delta-opioid receptor ligands and mixed agonists of opioid receptor-like 1/mu receptors may offer hope for new opioid-based drug discovery for chronic cough.

导言:人们日益认识到,慢性咳嗽是一种独特的临床症状,影响着全球相当一部分人口。尽管在了解其病理生理学方面取得了进展,但治疗方案仍然有限。长期以来,阿片类镇痛药一直被用于治疗咳嗽,其中一些已被证明具有明显的止咳潜力。然而,这些药物尚未被监管机构批准用于治疗慢性咳嗽。一些新型合成阿片调节剂在早期研究中显示出止咳效果,但也未能应用于临床实践:本微型综述旨在总结阿片受体在止咳药研发中的意义,并重点介绍阿片类镇痛药在止咳试验中的最新进展。检索了 PUB MED/CINAHL/Web of Science/Scopus(2024 年 9 月):我们对咳嗽的确切作用部位和外周阿片受体参与情况的了解仍然有限。尽管存在这些知识空白,但在出现更多新型有效治疗方法之前,阿片类药物仍是一些患者的可行选择。由于阿片类药物经常出现副作用,因此需要性能更好的新型阿片类药物衍生物。开发定制的或偏向δ-阿片受体配体以及阿片受体样1/mu受体的混合激动剂可能会为基于阿片的慢性咳嗽新药研发带来希望。
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引用次数: 0
Shadows and lights in sepsis immunotherapy. 败血症免疫疗法中的光与影
IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2024-10-21 DOI: 10.1080/14656566.2024.2418987
Guillaume Monneret, Muzhda Haem Rahimi, Anne-Claire Lukaszewicz, Fabienne Venet, Morgane Gossez

Introduction: Sepsis remains a major global public health challenge. The host's response in sepsis involves both an exaggerated inflammatory reaction and immunosuppressive mechanisms. A better understanding of this response has shed light on the failure of anti-inflammatory therapies administered under the 'one size fits all' approach during the last decades.

Areas covered: To date, patients' management has moved toward a comprehensive precision medicine approach that aims to personalize immunotherapy, whether anti-inflammatory or immunostimulatory. Large Prospective interventional randomized controlled trials validating this approach are about to start. A crucial prerequisite for these studies is to stratify patients based on biomarkers that will help defining the patients' immuno-inflammatory trajectory.

Expert opinion: Some biomarkers are already available in routine clinical care, while improvements are anticipated through the standardized use of transcriptomics and other multi-omics technologies in this field. With these precautions in mind, it is reasonable to anticipate improvement in outcomes in sepsis.

引言败血症仍然是全球公共卫生面临的一大挑战。脓毒症的宿主反应包括夸张的炎症反应和免疫抑制机制。对这一反应的深入了解,揭示了过去几十年来 "一刀切 "式抗炎疗法的失败原因:迄今为止,对患者的管理已转向全面的精准医学方法,该方法旨在实现免疫疗法的个性化,无论是抗炎疗法还是免疫刺激疗法。验证这种方法的大型前瞻性干预随机对照试验即将启动。这些研究的一个重要前提是根据生物标志物对患者进行分层,这将有助于确定患者的免疫炎症轨迹:专家意见:一些生物标志物已经可以在常规临床护理中使用,而通过在该领域标准化使用转录组学和其他多组学技术,生物标志物有望得到改进。考虑到这些预防措施,我们有理由期待败血症的治疗效果会有所改善。
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引用次数: 0
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Expert Opinion on Pharmacotherapy
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