Clinical application and recent research progress of novel drugs in bronchial asthma

doi:10.3877/cma.j.issn.1674-6902.2026.03.027

Abstract

Ming Long, Yan Zhao, Zhan Gao. Clinical application and recent research progress of novel drugs in bronchial asthma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(03): 510-515.

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References 40

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药物类别	代表药物	作用靶点	适用人群	给药方式	主要不良反应
抗IgE单抗	奥马珠单抗(omalizumab)	游离IgE、FcεRI受体	中重度过敏性支气管哮喘、IgE升高者	皮下注射，每2~4周	注射部位反应、过敏反应
抗IL-5单抗	美泊利珠单抗(mepolizumab)、瑞利珠单抗(reslizumab)	IL-5、IL-5Rα	啫酸性粒细胞表型≥150个/μl	皮下/静脉，每4周	头痛、鼻咽炎
抗IL-4/IL-13双靶点	度普利尤单抗(dupilumab)	LL-4Rα(阻断IL-4＋IL-13)	中-重度支气管哮喘伴2型炎症	皮下注射，每2周	注射部位反应，结膜炎
抗TSLP单抗	特泽鲁单抗(tezepelumab)	TSLP(胸腺基质淋巴细胞生成素)	重度支气管哮喘、不论嗜酸性粒细胞水平	皮下注射，每4周	头痛、鼻咽炎
抗IL-33单抗	伊托鲁单抗(itepekimab)	抗IL-33	2型支气管哮喘(在研阶段)	皮下注射	安全性评估中
抗GM-CSF单抗	奥替利珠单抗(otilimab)	GM-CSF	嗜中性粒细胞表型，重度支气管哮喘	皮下注射	注射部位反应

药物类别	代表药物	作用靶点	适用人群	给药方式	主要不良反应
抗IgE单抗	奥马珠单抗(omalizumab)	游离IgE、FcεRI受体	中重度过敏性支气管哮喘、IgE升高者	皮下注射，每2~4周	注射部位反应、过敏反应
抗IL-5单抗	美泊利珠单抗(mepolizumab)、瑞利珠单抗(reslizumab)	IL-5、IL-5Rα	啫酸性粒细胞表型≥150个/μl	皮下/静脉，每4周	头痛、鼻咽炎
抗IL-4/IL-13双靶点	度普利尤单抗(dupilumab)	LL-4Rα(阻断IL-4＋IL-13)	中-重度支气管哮喘伴2型炎症	皮下注射，每2周	注射部位反应，结膜炎
抗TSLP单抗	特泽鲁单抗(tezepelumab)	TSLP(胸腺基质淋巴细胞生成素)	重度支气管哮喘、不论嗜酸性粒细胞水平	皮下注射，每4周	头痛、鼻咽炎
抗IL-33单抗	伊托鲁单抗(itepekimab)	抗IL-33	2型支气管哮喘(在研阶段)	皮下注射	安全性评估中
抗GM-CSF单抗	奥替利珠单抗(otilimab)	GM-CSF	嗜中性粒细胞表型，重度支气管哮喘	皮下注射	注射部位反应

药物类别	代表药物	作用机制	临床优势	给药方式	注意事项
吸入型糖皮质激素(ICS)	布地奈德、氟替卡松、莫米松	激活糖皮质激素受体、抑制NF-κB通路、减少细胞因子基团转录	局部抗炎、全身副作用小、一线控制药物	吸入给药，每周1~2次	长期高剂量，可致口腔念珠茵、骨质疏松风险
长效β₂受体激动剂(LABA)	沙美特罗、福莫特罗、维兰特罗	激活β₂受体、↑cAMP→松弛平滑肌起效快(3~5 min)	快速缓解症状与ICS联合增效，改善肺功能	吸入给药，每日2次(维持)	不单独用于支气管哮喘控制，可能致震颤
白三烯受体拮抗剂(LTRA)	孟鲁司特、扎鲁司特	竞争性阻断CysLT₁受体	口服给药方便，轻度支气管哮喘单药，运动性支气管哮喘预防	口服，每日1次	精神神经不良，反应需关注，疗效个体差异大
JAK抑制剂	乌帕替尼(upadacitinib)、巴瑞替尼	抑制JAK1/JAK2、阻断STAT磷酸化、减少IL-4/IL-13/IL-5	口服靶向治疗、2型支气管哮喘有效，生物制剂替代方案	口服，每日1次	感染风险增加，需监测血常规，带状疱疹风险
磷酸二酯酶-4抑制剂(PDE4)	罗氟司特(roflumilast)	抑制PDE4↑cAMP→抗炎，松弛平滑肌	口服给药，中重度COPD合并支气管哮喘患者	口服，每日1次	恶心腹泻、常见体重减轻
新型吸入型LAMA	格隆溴铵、乌美溴铵	阻断M₃受体，抑制乙酰胆碱→平滑肌松弛	长效(24 h)与LABA＋ICS三联疗效协同	吸入给药，每日1次	口干、尿潴留(少见)、青光眼慎用

药物类别	代表药物	作用机制	临床优势	给药方式	注意事项
吸入型糖皮质激素(ICS)	布地奈德、氟替卡松、莫米松	激活糖皮质激素受体、抑制NF-κB通路、减少细胞因子基团转录	局部抗炎、全身副作用小、一线控制药物	吸入给药，每周1~2次	长期高剂量，可致口腔念珠茵、骨质疏松风险
长效β₂受体激动剂(LABA)	沙美特罗、福莫特罗、维兰特罗	激活β₂受体、↑cAMP→松弛平滑肌起效快(3~5 min)	快速缓解症状与ICS联合增效，改善肺功能	吸入给药，每日2次(维持)	不单独用于支气管哮喘控制，可能致震颤
白三烯受体拮抗剂(LTRA)	孟鲁司特、扎鲁司特	竞争性阻断CysLT₁受体	口服给药方便，轻度支气管哮喘单药，运动性支气管哮喘预防	口服，每日1次	精神神经不良，反应需关注，疗效个体差异大
JAK抑制剂	乌帕替尼(upadacitinib)、巴瑞替尼	抑制JAK1/JAK2、阻断STAT磷酸化、减少IL-4/IL-13/IL-5	口服靶向治疗、2型支气管哮喘有效，生物制剂替代方案	口服，每日1次	感染风险增加，需监测血常规，带状疱疹风险
磷酸二酯酶-4抑制剂(PDE4)	罗氟司特(roflumilast)	抑制PDE4↑cAMP→抗炎，松弛平滑肌	口服给药，中重度COPD合并支气管哮喘患者	口服，每日1次	恶心腹泻、常见体重减轻
新型吸入型LAMA	格隆溴铵、乌美溴铵	阻断M₃受体，抑制乙酰胆碱→平滑肌松弛	长效(24 h)与LABA＋ICS三联疗效协同	吸入给药，每日1次	口干、尿潴留(少见)、青光眼慎用

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