Asma de control dif铆cil: factores predisponentes y factores agravantes

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• 作者：M. Garcí ; a-Salmones Martí ; n^a ; ^{mgsalmones@fhalarcon.es} ; C. Melero Moreno^b ; A. Ló ; pez Viñ ; a^c ; C. Cisneros Serrano^e ; J.J. Jareñ ; o Esteban^d ; Grupo de Asma de Neumomadrid
• 关键词：Asma de control difí ; cil ; Asma refractaria ; Asma resistente al tratamiento ; Asma resistente a glucocorticoides ; Asma corticodependiente ; Asma difí ; cil ; Asma grave
• 刊名：Revista de Patolog铆a Respiratoria
• 出版年：2011
• 期刊代码：pca325_15769895
• 类别：med
• 出版时间：January-March 2011
• 卷：14
• 期：1
• 页码：26-32
• 文件大小：195 K

摘要

The concept of difficult-to-control asthma covers all those patients with insufficiently or poorly controlled asthma who, in spite of having followed an appropriate therapeutic strategy, and after having verified its compliance, other diseases have been ruled out and aggravating factors of the disease controlled. The factors that contribute to making asthma refractory to treatment are not well known. Some studies establish weak associations between certain genetic alterations and several environmental factors. It has been described that mutations of the IL-4 gene and its receptor seem to have a relationship with loss of pulmonary function and with life-threatening asthma episodes. They have also been related with the severity of the asthma factors involved in airway remodeling and mutations of glucocorticoids and beta 2-adrenergic receptors. On the other hand, different environmental factors such as continuing exposure to allergens, tobacco smoke, intolerance to NSAIDs and infections have been associated with the severity of asthma.

Multicenter study such as the ENFUMOSA study and the TENOR study have partially helped us to understand this disease.