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Abstract：
In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis, and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis, and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping, and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers, are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2, and COVID-19.
摘要：
在这次审查中,我们讨论了最近关于哮喘的出版物，并回顾了报道了患病率不同方面的研究，危险因素和预防，机制,诊断,和哮喘的治疗。许多危险和保护因素及分子机制参与了哮喘的发生发展。回顾了实施暴露范例及其在过敏性疾病和哮喘中的应用的新兴概念和挑战。包括遗传和表观遗传因素，微生物菌群失调，和环境暴露，特别是室内和室外物质。讨论了最相关的实验研究，以进一步促进对分子和免疫机制的理解，并讨论了治疗方法开发的潜在新靶标。哮喘的可靠诊断，疾病分型，监测其严重程度对哮喘的治疗具有重要意义。正确评估和管理哮喘共病/多病，包括与哮喘表型的相互作用及其对精准医学方法和预测生物标志物验证的价值，进一步详细。哮喘治疗的新方法和策略与哮喘的机制和内生型有关，特别是生物制品，受到严格评价。最后,由于最近的大流行及其对患者管理的影响，我们讨论挑战，关系,和哮喘之间的分子机制，过敏,SARS-CoV-2和COVID-19。
