Asma: uma revisão sobre a fisiopatologia e as novas abordagens terapêuticas

Abstract

Objective: To describe the physiopathology of asthma correlating it with new therapeutic approaches. Literature review: Asthma is a chronic inflammatory disease of heterogeneous nature whose manifestation is related not only to atopic conditions but also to factors such as airway infections, aging, and overweight. Despite the existence of different allergic and non-allergic physiopathological mechanisms, asthma symptoms commonly manifest as dyspnea, wheezing, and cough. Chronic airway inflammation is mediated by pro- inflammatory cells and molecules of innate immunity and components of adaptive immunity such as CD3+CD4+ T lymphocytes (Th1, Th2, Th17). Diagnosis is achieved through clinical correlation with pulmonary function tests. Conventional asthma treatment is based on the use of bronchodilators and inhaled corticosteroids. However, there is a subset of asthmatic patients whose disease exacerbations are not controlled by such medications. For these patients, it is necessary to introduce individualized therapy, evaluating endotyping and the use of biological therapies and immunotherapy. Final considerations: The physiopathology of asthma is related to the activation of the immune system; thus, understanding its endotypes and instituting treatment based on knowledge of immunopathological mechanisms are essential for providing effective management.