Таргетная терапия бронхиальной астмы у детей и подростков: описательный обзор

Цель. Провести оценку результатов клинических исследований, посвящённых изучению эффективности и безопасности терапии бронхиальной астмы (БА) генно-инженерными биологическими препаратами (ГИБП) у детей и подростков.

Материалы и методы. Для написания данной обзорной статьи был проведён поиск полнотекстовых публикаций в базе данных PubMed. Были проанализированы работы по изучению эффективности и безопасности применения биологических препаратов — моноклональных антител, в лечении БА, рефрактерной к терапии ингаляционными глюкокортикостероидами и бета-2-агонистами, у детей и подростков с 2010 по 2025 гг. с использованием следующих ключевых запросов: «bronchial asthma», «monoclonal antibodies», «anti-IgE antibody», «anti-IL-receptor antibody», «anti-thymic stromal lymphopoietin antibody», «adolescents», «children».

Результаты. Наблюдаемый продолжающийся и неуклонный рост заболеваемости БА, вовлечённость нескольких систем органов в патологический процесс, сложность выбора тактики лечения, высокая стоимость терапии и необходимость в мониторинге состояния пациента ставят рассматриваемое заболевание на особое место среди современных проблем медицины. На сегодняшний день достижения в области генной инженерии позволили внедрить в медицинскую практику ГИБП — препараты моноклональных антител, в качестве одной из ступеней лечения плохо контролируемой и резистентной к терапии препаратами первой линии БА средней и тяжёлой степени тяжести. По данным последних клинических исследований среди детей и подростков, биологические препараты в разной степени способны влиять на контроль симптомов, функцию лёгких, частоту обострений, обращений за неотложной медицинской помощью и госпитализаций, а также снижение дозировок применяемых глюкокортикостероидов и бета-2-агонистов.

Заключение. На сегодняшний день отмечаются положительные результаты применения моноклональных антител в терапии БА, однако данные клинических исследований среди детей и подростков ограничены. Также недостаточно информации о последствиях механизма действия данных препаратов в отношении длительного ингибирования иммунной системы и снижения содержания эозинофилов в сыворотке крови в развивающемся организме ребенка. Для формулирования окончательного вывода необходимо дальнейшее изучение долгосрочной эффективности и безопасности применения биологических препаратов в педиатрической практике в целях борьбы с этой серьезной общественной угрозой.

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