{"created":"2024-08-30T04:03:16.056121+00:00","id":2000304,"links":{},"metadata":{"_buckets":{"deposit":"a8332cb9-c610-4e64-b9d5-888db20ec35b"},"_deposit":{"created_by":14,"id":"2000304","owner":"14","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"2000304"},"status":"published"},"_oai":{"id":"oai:dmu.repo.nii.ac.jp:02000304","sets":["81:1724903586492"]},"author_link":[],"control_number":"2000304","item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-07-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"18","bibliographicPageStart":"10","bibliographicVolumeNumber":"51","bibliographic_titles":[{"bibliographic_title":"Dokkyo Journal of Medical Sciences"}]}]},"item_10001_description_6":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"喘息の有病率は年々増加傾向だが喘息死は減少してきている．喘息死者数は 70 歳以上にピークがあり若年者は少数である．注目されている喘息の病態は，気道上皮傷害により上皮から産生される interleukin（IL）-33, IL-25, thymic stromal lymphopoietin（TSLP）が Th2 細胞，group 2 innate lymphoid cells（ILC2）や dendritic cells（DC）に作用し自然免疫と獲得免疫のクロストークの橋渡しをし病態を形成している機序である．近年の気道上皮の解析の進歩により tuft 細胞が IL-25 産生細胞であることが示唆されている．喘息の治療では，長期管理薬の吸入ステロイド（inhaled corticosteroids, ICS），長時間作用性 b2 刺激薬（long-acting b-agonist, LABA）と長時間作用性抗コリン薬（long-acting muscarinic antagonist, LAMA）が 1 つの吸入容器で 1 日 1 回吸入型の single inhaler triple therapy（SITT）製剤が使用できるようになり，薬剤の相加相乗効果や患者のアドヒアランスの向上による良好な喘息コントロールが期待できる．吸入剤や経口コルチコステロイド治療にてもコントロールができない重症喘息患者はステロイド抵抗性があると考えられ生物学的製剤が使用される．血中好酸球数や呼気一酸化窒素（FeNO）の値が高いタイプ 2 炎症を呈する患者が生物学的製剤の良い適応である．喘息治療の進歩により臨床的寛解，すなわち症状なし，増悪なし，経口ステロイド治療無し，肺機能の安定化といったことが達成されうる患者が約 2〜3 割いる．今後の課題として，臨床的な寛解が得られない患者は依然として多いため，さらに精度の高い治療選択を行うためのバイオマーカーと薬剤開発が求められている","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Prevalence of asthma is increasing each year, but asthma deaths are declining. A peak in the number of asthma deaths is observed in people over 70 years of age, with a small number of deaths among younger people. Highlighted pathogenesis of asthma is mediated by interleukin（IL）-33, IL-25, and thymic stromal lymphopoietin（TSLP）, which are released from the epithelium after airway epithelial injury, acting on Th2 cells, group 2 innate lymphoid cells（ILC2）and dendritic cells（DCs）, bridging the crosstalk between innate and acquired immunity and promoting inflammation. Recent advances in the analysis of airway epithelium have suggested that tuft cells are IL-25 producing cells. In the treatment of asthma, inhaled corticosteroids（ICS）, long-acting beta-agonists（LABA）, and longacting muscarinic（long-acting muscarinic antagonist, LAMA）in a single inhaler triple therapy（SITT）, which is a once-daily inhaler in a single inhaler container, is expected to provide better asthma control through synergistic effects of the drugs and improved patient adherence. Patients with severe asthma that is not controlled by inhaled or oral corticosteroid therapy are considered steroid-resistant and are treated with biologics. Patients with type 2 inflammation with high blood eosinophil counts and fraction of exhaled nitric oxide（FeNO）levels are good candidates for biologics. With advances in asthma treatment, clinical remission, i.e., no symptoms, no exacerbations, no oral corticosteroid therapy, and stabilization of lung function, can be achieved in about 20〜30% of patients. The challenge for the future is to develop biomarkers and drugs for more precise treatment selection, since many patients still do not achieve clinical remission.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"獨協医学会"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA00629581","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-5023","subitem_source_identifier_type":"PISSN"}]},"item_10001_text_29":{"attribute_name":"特集名(日)","attribute_value_mlt":[{"subitem_text_language":"ja","subitem_text_value":"アレルギーの up to date ―最近のトピックス―（前編）"}]},"item_10001_text_30":{"attribute_name":"特集名(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Allergy Up to Date ─Recent Topics─（Part1）"}]},"item_10001_text_33":{"attribute_name":"記事種別","attribute_value_mlt":[{"subitem_text_value":"総説"}]},"item_10001_version_type_20":{"attribute_name":"出版タイプ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"清水, 泰生","creatorNameLang":"ja"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2024-08-30"}],"filename":"DKMJ-51-1-4.pdf","filesize":[{"value":"788 KB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"url":"https://dmu.repo.nii.ac.jp/record/2000304/files/DKMJ-51-1-4.pdf"},"version_id":"55d4c095-7445-4068-b844-11bdcf36c4e5"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"喘息","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"自然免疫","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"MAIT細胞","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"生物学的製剤","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"臨床的寛解","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"Asthma","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"innate immunity","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"MAIT cells","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"biologics","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"clinical remission","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"成人気管支喘息 up to date","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"成人気管支喘息 up to date","subitem_title_language":"ja"},{"subitem_title":"Up to Date of Adult Bronchial Asthma","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"14","path":["1724903586492"],"publish_date":"2024-08-30","publish_status":"0","recid":"2000304","relation_version_is_last":true,"title":["成人気管支喘息 up to date"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2024-09-06T00:10:10.237914+00:00"}