Материалы и методы

pulmo

Пульмонология

PULMONOLOGIYA

0869-01892541-9617

Scientific and Practical Journal “PULMONOLOGIYA” LLC

10.18093/0869-0189-2025-35-4-540-552

pulmo-4792

Research Article

ОБЗОРЫ

REVIEW

Окислительный стресс у пациентов с тяжелой бронхиальной астмой

Oxidative stress in patients with severe asthma

https://orcid.org/0009-0008-7529-6690

Нгуен

В. Ч.

Nguyen

Van Truong

Нгуен Ван Чыонг – аспирант кафедры госпитальной терапии Института материнства и детства

Van Truong Nguyen, Postgraduate Student, Department of Hospital Therapy, Institute of Maternity and Childhood

ul. Ostrovityanova 1, Moscow, 117997

dr.nguyentruong@mail.ru

https://orcid.org/0000-0001-5618-5671

Солдатов

Д. Г.

Soldatov

D. G.

Солдатов Дмитрий Германович – к. м. н., доцент, доцент кафедры госпитальной терапии Института материнства и детства

Dmitry G. Soldatov, Candidate of Medicine, Associate Professor, Assistant Professor of the Department of Hospital Therapy, Institute of Maternity and Childhood

ul. Ostrovityanova 1, Moscow, 117997

d.g.soldatov@mail.ru

Федеральное государственное автономное образовательное учреждение высшего образования «Российский национальный исследовательский медицинский университет имени Н.И.Пирогова» Министерства здравоохранения Российской ФедерацииРоссияFederal State Autonomous Educational Institution of Higher Education “N.I.Pirogov Russian National Research Medical University” of the Ministry of Health of the Russian FederationRussian Federation

2025

08082025

354540552

2025

Нгуен В.Ч., Солдатов Д.Г.

Nguyen V.T., Soldatov D.G.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://journal.pulmonology.ru/pulm/article/view/4792

По результатам многочисленных исследований последних лет продемонстрировано, что одним из важнейших патофизиологических механизмов формирования хронического воспаления в стенке бронхов больных бронхиальной астмой (БА) является окислительный стресс (ОС). ОС способствует хронизации воспаления и ремоделированию дыхательных путей.

Целью обзора явилось изучение роли ОС у больных тяжелой БА (ТБА) и возможностей его терапевтической коррекции на основании анализа литературных источников баз данных PubMed и Google Scholar за период 2020–2025 гг.

Материалы и методы

Материалы и методы. Изучены 83 публикации баз данных PubMed и Google Scholar, отобранные в результате поиска по следующим ключевым словам: «окислительный / оксидативный стресс при тяжелой бронхиальной астме», «лечение окислительного стресса при тяжелой бронхиальной астме», «антиоксидантная терапия при тяжелой бронхиальной астме».

Заключение

Заключение. Сделан вывод о том, что ОС играет важнейшую роль в патогенезе ТБА, способствуя формированию и поддержанию хронического воспаления в бронхиальной стенке, гиперреактивности и ремоделированию бронхов, персистенции симптомов и снижению вентиляционной функции легких. Поиск и разработка инновационных методов лечения, направленных на уменьшение выраженности ОС в стенке бронхов, в частности ингаляционная терапия термической гелий-кислородной смесью, может представлять особой интерес в комплексной терапии ТБА с целью установления наиболее полного контроля над заболеванием.

Numerous studies in recent years have demonstrated that oxidative stress (OS) is one of the most important pathophysiologic mechanisms of chronic inflammation in the bronchial wall of asthma patients. OS contributes to chronic inflammation and airway remodeling.

The aim of this review was to investigate the role of OS in patients with severe asthma (SA) and therapeutic options for OS improvement based on analysis of literature data from PubMed and Google Scholar databases for the period 2020 – 2025.

Methods

Methods. 83 PubMed and Google Scholar publications were selected for the review by searching the following keywords: oxidative stress in SA, OS treatment in SA, and antioxidant therapy in SA.

Conclusion

Conclusion. OS plays a crucial role in the pathogenesis of SA, contributing to the formation and maintenance of chronic inflammation in the bronchial wall, bronchial hyperreactivity and remodeling, persistence of symptoms, and decreased ventilatory function of the lungs. Search and development of innovative treatment methods aimed at reducing the severity of OS in the bronchial wall, in particular inhalation therapy with a thermal helium-oxygen mixture, may be of particular interest in the complex therapy of SA in order to establish the most comprehensive control of the disease.

тяжелая бронхиальная астмаокислительный / оксидативный стресссвободные кислородные радикалыконтроль над бронхиальной астмойантиоксидантная терапия

severe asthmaoxidative stressfree oxygen radicalsasthma controlantioxidant therapy

References1

Rajvanshi N., Kumar P., Goyal J.P. Global initiative for asthma guidelines 2024: an update. Indian Pediatr. 2024; 61 (8): 781–786. DOI: 10.1007/s13312-024-3260-7.

Центральный научно-исследовательский институт организации и информатизации здравоохранения Минздрава России. 2024. Доступно на: https://mednet.ru/

Российское респираторное общество. Клинические рекомендации: Бронхиальная астма. 2024. Доступно на: https://spulmo.ru/upload/KR-bronhialnaya-astma-2024.pdf

Зырянов С.К., Дьяков И.Н., Карпов О.И. Моделирование влияния иммунобиологических препаратов на экономическое бремя тяжелой бронхиальной астмы. Качественная клиническая практика. 2019 (3): 4–12. DOI: 10.24411/2588-0519-2019-10078.

Juan C.A., Pérez de la Lastra J.M., Plou F.J., Pérez-Lebeña E. The chemistry of reactive oxygen species (ROS) revisited: outlining their role in biological macromolecules (DNA, lipids and proteins) and induced pathologies. Int. J. Mol. Scie. 2021; 22 (9): 4642. DOI: 10.3390/ijms22094642.

Michaeloudes C., Abubakar-Waziri H., Lakhdar R. et al. Molecular mechanisms of oxidative stress in asthma. Mol. Aspects Med. 2022; 85: 101026. DOI: 10.1016/j.mam.2021.101026.

Vincenzo S.D., Ferrante G., Ferraro M. et al. Oxidative stress, environmental pollution, and lifestyle as determinants of asthma in children. Biology (Basel). 2023; 12 (1): 133. DOI: 10.3390/biology12010133.

Zuo L., Koozechian M.S., Chen L.L. Characterization of reactive nitrogen species in allergic asthma. Ann. Allergy Asthma Immunol. 2014; 112 (1): 18–22. DOI: 10.1016/j.anai.2013.10.007.

Колпакова А.Ф., Шарипов Р.Н., Волкова О.А., Колпаков Ф.А. О роли загрязнения воздуха взвешенными частицами в патогенезе сердечно-сосудистых заболеваний. Меры профилактики. Кардиоваскулярная терапия и профилактика. 2020; 19 (3): 2421. DOI: 10.15829/1728-8800-2020-2421.

Liu K., Hua S., Song L. PM2. 5 exposure and asthma development: the key role of oxidative stress. Oxid. Med. Cell. Longev. 2022; 2022: 3618806. DOI: 10.1155/2022/3618806.

Liu Q., Weng J., Li C. et al. Attenuation of PM2.5-induced alveolar epithelial cells and lung injury through regulation of mitochondrial fission and fusion. Part. Fibre Toxicol. 2023; 20 (1): 28. DOI: 10.1186/s12989-023-00534-w.

Hashemzadeh B., Idani E., Goudarzi G. et al. Effects of PM2.5 and NO2 on the 8-isoprostane and lung function indices of FVC and FEV1 in students of Ahvaz city, Iran. Saudi J. Biol. Scie. 2019; 26 (3): 473–480. DOI: 10.1016/j.sjbs.2016.11.008.

Marsal A., Sauvain J.J., Thomas A. et al. Effects of personal exposure to the oxidative potential of PM2.5 on oxidative stress biomarkers in pregnant women. Scie. Total Environ. 2024; 911: 168475. DOI: 10.1016/j.scitotenv.2023.168475.

Liang Y., Chu P.H., Tian L. et al. Targeting mitochondrial permeability transition pore ameliorates PM2.5-induced mitochondrial dysfunction in airway epithelial cells. Environ. Pollut. 2022; 295: 118720. DOI: 10.1016/j.envpol.2021.118720.

Ni R., Su H., Burnett R.T. et al. Long-term exposure to PM2.5 has significant adverse effects on childhood and adult asthma: a global meta-analysis and health impact assessment. One Earth. 2024; 7 (11): 1953–1969. DOI: 10.1016/j.oneear.2024.09.022.

Ho T.H., Van Dang C., Pham T.T.B. et al. Assessment of the association between PM2.5 concentration and hospital admissions for pediatric asthma in Ho Chi Minh City, Viet Nam. Hygiene Environmental Health Advances. 2024; 11: 100097. DOI: 10.1016/j.heha.2024.100097.

Bromberg PA. Mechanisms of the acute effects of inhaled ozone in humans. Biochim. Biophys. Acta. 2016; 1860 (12): 2771–2781. DOI: 10.1016/j.bbagen.2016.07.015.

Wiegman C.H., Li F., Ryffel B. et al. Oxidative stress in ozone-induced chronic lung inflammation and emphysema: a facet of chronic obstructive pulmonary disease. Front. Immunol. 2020; 11: 1957. DOI: 10.3389/fimmu.2020.01957.

Sun N., Niu Y., Zhang R. et al. Ozone inhalation induces exacerbation of eosinophilic airway inflammation and Th2-skew immune response in a rat model of AR. Biomed. Pharmacother. 2021; 137: 111261. DOI: 10.1016/j.biopha.2021.111261.

Arjomandi M., Wong H., Tenney R. et al. Effect of ozone on allergic airway inflammation. J. Allergy Clin. Immunol. Global. 2022; 1 (4): 273–281. DOI: 10.1016/j.jacig.2022.05.007.

Fang X., Huang S., Zhu Y. et al. Short-term exposure to ozone and asthma exacerbation in adults: a longitudinal study in China. Front. Public Health. 2022; 10: 1070231. DOI: 10.3389/fpubh.2022.1070231.

Huang W., Wu J., Lin X. Ozone exposure and asthma attack in children. Front. Pediatr. 2022; 10: 830897. DOI: 10.3389/fped.2022.830897.

Holm S.M., Balmes J.R. Systematic review of ozone effects on human lung function, 2013 through 2020. Chest. 2022; 161 (1): 190–201. DOI: 10.1016/j.chest.2021.07.2170.

Seo Y.S., Park J.M., Kim J.H., Lee M.Y. Cigarette smoke-induced reactive oxygen species formation: a concise review. Antioxidants (Basel). 2023; 12 (9): 1732. DOI: 10.3390/antiox12091732.

Emma R., Caruso M., Campagna D. et al. The impact of tobacco cigarettes, vaping products and tobacco heating products on oxidative stress. Antioxidants (Basel). 2022; 11 (9): 1829. DOI: 10.3390/antiox11091829.

Lewis B.W., Ford M.L., Rogers L.K., Britt R.D. Oxidative stress promotes corticosteroid insensitivity in asthma and COPD. Antioxidants (Basel). 2021; 10 (9): 1335. DOI: 10.3390/antiox10091335.

Chatterjee S., Tao J.Q., Johncola A. et al. Acute exposure to e-cigarettes causes inflammation and pulmonary endothelial oxidative stress in nonsmoking, healthy young subjects. Am. J. Physiol. Lung Cell. Mol. Physiol. 2019; 317 (2): L155–166. DOI: 10.1152/ajplung.00110.2019.

Colsoul M., Goderniaux N., Onorati S. et al. Biological effect of cigarette smoking in endothelial dysfunction: study of biomarkers of endothelial function, oxidative stress, inflammation, and lipids. Eur. J. Environment Public Health. 2023; 7 (3): em0136. DOI: 10.29333/ejeph/12995.

Hutchinson A., ElBagoury M. Inflammation and oxidative stress from E-cigarette exposure: implications for COPD and asthma. J. Pharmaceutical Res. Int. 2022; 34 (38B): 33–50. DOI: 10.9734/jpri/2022/v34i38B36225.

Li X., Zhang Y., Zhang R. et al. Association between E-cigarettes and asthma in adolescents: a systematic review and meta-analysis. Am. J. Prev. Med. 2022; 62 (6): 953–960. DOI: 10.1016/j.amepre.2022.01.015.

Villalpando-Rodriguez G.E., Gibson S.B. Reactive Oxygen Species (ROS) regulates different types of cell death by acting as a rheostat. Oxid. Med. Cell. Longev. 2021; 2021: 9912436. DOI: 10.1155/2021/9912436.

Allam V., Paudel K.R., Gupta G. et al. Nutraceuticals and mitochondrial oxidative stress: bridging the gap in the management of bronchial asthma. Environ. Sci. Pollut. Res. Int. 2022; 29 (42): 62733–62754. DOI: 10.1007/s11356-022-21454-w.

Guo Q., Jin Y., Chen X. et al. NF-κB in biology and targeted therapy: new insights and translational implications. Signal Transduct. Target. Ther. 2024; 9 (1): 53. DOI: 10.1038/s41392-024-01757-9.

Jomova K., Raptova R., Alomar S.Y. et al. Reactive oxygen species, toxicity, oxidative stress, and antioxidants: chronic diseases and aging. Arch. Toxicol. 2023; 97 (10): 2499–2574. DOI: 10.1007/s00204-023-03562-9.

Pelaia C., Vatrella A., Gallelli L. et al. Role of p38 mitogen-activated protein kinase in asthma and COPD: pathogenic aspects and potential targeted therapies. Drug Des. Devel. Ther. 2021; 15: 1275–1284. DOI: 10.2147/dddt.S300988.

Nakagome K., Nagata M. The possible roles of IL-4/IL-13 in the development of eosinophil-predominant severe asthma. Biomolecules. 2024; 14 (5): 546. DOI: 10.3390/biom14050546.

Pelaia C., Heffler E., Crimi C. et al. Interleukins 4 and 13 in asthma: key pathophysiologic cytokines and druggable molecular targets. Front. Pharmacol. 2022; 13: 851940. DOI: 10.3389/fphar.2022.851940.

Lambrecht B.N., Hammad H., Fahy J.V. The cytokines of asthma. Immunity. 2019; 50 (4): 975–991. DOI: 10.1016/j.immuni.2019.03.018.

Schleich F., Brusselle G., Louis R. et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian severe asthma registry (BSAR). Respir. Med. 2014; 108 (12): 1723–1732. DOI: 10.1016/j.rmed.2014.10.007.

Ненашева Н. Тяжелая эозинофильная бронхиальная астма: новые возможности терапии. Медицинский совет. 2018; (15): 44–52. DOI: 10.21518/2079-701X-2018-15-44-52.

Koranteng J., Chung K.F., Michaeloudes C., Bhavsar P. The role of mitochondria in eosinophil function: implications for severe asthma pathogenesis. Front. Cell Dev. Biol. 2024; 12: 1360079. DOI: 10.3389/fcell.2024.1360079.

Zhang X., Xu Z., Wen X. et al. The onset, development and pathogenesis of severe neutrophilic asthma. Immunol. Cell Biol. 2022; 100 (3): 144–159. DOI: 10.1111/imcb.12522.

Mao R., Jiang Z., Min Z. et al. Peripheral neutrophils and oxidative stress-associated molecules for predicting the severity of asthma: a cross-sectional study based on multidimensional assessment. Front. Med. (Lausanne). 2023; 10: 1240253. DOI: 10.3389/fmed.2023.1240253.

Федоров А., Ермак Н., Геращенко Т. и др. Поляризация макрофагов: механизмы, маркеры и факторы индукции. Сибирский онкологический журнал. 2022; 21 (4): 124–136. DOI: 10.21294/1814-4861-2022-21-4-124-136.

Wang P., Geng J., Gao J. et al. Macrophage achieves self-protection against oxidative stress-induced ageing through the Mst-Nrf2 axis. Nature Communications. 2019; 10 (1): 755. DOI: 10.1038/s41467-019-08680-6.

Canton M., Sánchez-Rodríguez R., Spera I. et al. Reactive oxygen species in macrophages: sources and targets. Front. Immunol. 2021; 12: 734229. DOI: 10.3389/fimmu.2021.734229.

de Groot L.E., Van Der Veen T.A., Martinez F.O. et al. Oxidative stress and macrophages: driving forces behind exacerbations of asthma and chronic obstructive pulmonary disease? Am. J. Physiol. Lung Cell. Mol. Physiol. 2019; 316 (2): L369–384. DOI: 10.1152/ajplung.00456.2018.

Fricker M., Qin L., Sánchez‐Ovando S. et al. An altered sputum macrophage transcriptome contributes to the neutrophilic asthma endotype. Allergy. 2022; 77 (4): 1204–1215. DOI: 10.1111/all.15087.

Olgac M., Guler S.D., Demir S. et al., editors. Paucigranulocytic asthma: Do sputum macrophages matter? Allergy Asthma Proc. 2021; 42 (6): 530–536. DOI: 10.2500/aap.2021.42.210060.

Hough K.P., Curtiss M.L., Blain T.J. et al. Airway remodeling in asthma. Front. Med. (Lausanne). 2020; 7: 191. DOI: 10.3389/fmed.2020.00191.

Savin I.A., Zenkova M.A., Sen'kova A.V. Bronchial asthma, airway remodeling and lung fibrosis as successive steps of one process. Int. J. Mol. Sci. 2023; 24 (22). DOI: 10.3390/ijms242216042.

Raby K.L., Michaeloudes C., Tonkin J. et al. Mechanisms of airway epithelial injury and abnormal repair in asthma and COPD. Front. Immunol. 2023; 14: 1201658. DOI: 10.3389/fimmu.2023.1201658.

Hough K.P., Curtiss M.L., Blain T.J. et al. Airway remodeling in asthma. Front. Med. 2020; 7: 191. DOI: 10.3389/fmed.2020.00191.

Rupani H., Kent B.D. Using fractional exhaled nitric oxide measurement in clinical asthma management. Chest. 2022; 161 (4): 906–917. DOI: 10.1016/j.chest.2021.10.015.

Lipworth B., Kuo C.R., Chan R. 2020 updated asthma guidelines: clinical utility of fractional exhaled nitric oxide (FeNO) in asthma management. J. Allergy Clin. Immunol. 2020; 146 (6): 1281–1282. DOI: 10.1016/j.jaci.2020.03.006.

de Abreu F.C., da Silva Júnior J.L.R., Rabahi M.F. The fraction exhaled nitric oxide as a biomarker of asthma control. Biomark. Insights. 2019; 14: 1177271919826550. DOI: 10.1177/1177271919826550.

Elsheikh M.S., Mohamed N.H., Alsharkawy A.A.A. Improvement of asthma control after laser acupuncture and its impact on exhaled 8-isoprostane as an oxidative biomarker in chronic bronchial asthma. Respir. Med. 2019; 156: 15–19. DOI: 10.1016/j.rmed.2019.07.022.

Duchene B., Caffry S., Kaminsky D.A. et al. Functional significance of 8-isoprostanes in sinonasal disease and asthma. Respir. Med. 2021; 185: 106506. DOI: 10.1016/j.rmed.2021.106506.

БиоХимМак. Маркеры воспаления и окислительного стресса. 2024. Доступно на: https://biochemmack.ru/upload/uf/59e/59e74cd08ad31f9c72ede8466c1b211a.pdf

Cordiano R., Di Gioacchino M., Mangifesta R. et al. Malondialdehyde as a potential oxidative stress marker for allergy-oriented diseases: an update. Molecules. 2023; 28 (16): 5979. DOI: 10.3390/molecules28165979.

He L., Cui X., Li Z. et al. Malondialdehyde in nasal fluid: a biomarker for monitoring asthma control in relation to air pollution exposure. Environ. Sci. Technol. 2020; 54 (18): 11405–11413. DOI: 10.1021/acs.est.0c02558.

Stoodley I., Williams L., Thompson C. et al. Evidence for lifestyle interventions in asthma. Breathe (Sheff.). 2019; 15 (2): e50–61. DOI: 10.1183/20734735.0019-2019.

Hosseini B., Berthon B.S., Wark P., Wood L.G. Effects of fruit and vegetable consumption on risk of asthma, wheezing and immune responses: a systematic review and meta-analysis. Nutrients. 2017; 9 (4): 341. DOI: 10.3390/nu9040341.

Mendes F.C., Paciência I., Cavaleiro Rufo J. et al. Higher diversity of vegetable consumption is associated with less airway inflammation and prevalence of asthma in school-aged children. Pediatr. Allergy Immunol. 2021; 32 (5): 925–936. DOI: 10.1111/pai.13446.

Kim J.W., Kim J.H., Jeong J.S. et al. Green tea extract suppresses airway inflammation via oxidative stress-driven MAPKs/MMP-9 signaling in asthmatic mice and human airway epithelial cells. Front. Immunol. 2024; 15: 1362404. DOI: 10.3389/fimmu.2024.1362404.

Onur E., Kabaroğlu C., Günay Ö. et al. The beneficial effects of physical exercise on antioxidant status in asthmatic children. Allergol. Immunopathol. 2011; 39 (2): 90–95. DOI: 10.1016/j.aller.2010.04.006.

Fu Z., Zhang J. Molecular hydrogen is a promising therapeutic agent for pulmonary disease. J. Zhejiang Univ. Sci. B. 2022; 23 (2): 102–122. DOI: 10.1631/jzus.B2100420.

Gao X., Li Y., Wang H. et al. Inhibition of HIF‐1α decreases expression of pro‐inflammatory IL‐6 and TNF‐α in diabetic retinopathy. Acta Ophthalmol. 2017; 95 (8): e746–750. DOI: 10.1111/aos.13096.

Wan M., Yu Q., Xu F. et al. Novel hypoxia-induced HIF-1αactivation in asthma pathogenesis. Respir. Res. 2024; 25 (1): 287. DOI: 10.1186/s12931-024-02869-0.

Abdel-Fattah M.M., Salama A.A.A., Messiha B.A.S. Immunomodulatory and anti-inflammatory effects of N-acetylcysteine in ovalbumin-sensitized rats. Beni-Suef Univ. J. Basic Appl. Sci. 2022; 11 (1): 2. DOI: 10.1186/s43088-021-00188-7.

Janciauskiene S. The beneficial effects of antioxidants in health and diseases. Chronic. Obstr. Pulm. Dis. 2020; 7 (3): 182–202. DOI: 10.15326/jcopdf.7.3.2019.0152.

Mokra D., Mokry J., Barosova R., Hanusrichterova J. Advances in the use of N-acetylcysteine in chronic respiratory diseases. Antioxidants (Basel). 2023; 12 (9): 1713. DOI: 10.3390/antiox12091713.

Ghalibaf M.H.E., Kianian F., Beigoli S. et al. The effects of vitamin C on respiratory, allergic and immunological diseases: an experimental and clinical-based review. Inflammopharmacology. 2023; 31 (2): 653–672. DOI: 10.1007/s10787-023-01169-1.

Gęgotek A., Skrzydlewska E. Antioxidative and anti-Inflammatory activity of ascorbic acid. Antioxidants (Basel). 2022; 11 (10): 1993. DOI: 10.3390/antiox11101993.

Kianian F., Karimian S.M., Kadkhodaee M. et al. Protective effects of ascorbic acid and calcitriol combination on airway remodelling in ovalbumin-induced chronic asthma. Pharmaceutical Biology. 2020; 58 (1): 107–115. DOI: 10.1080/13880209.2019.1710218.

Провоторов В, Будневский А, Филатова Ю. Клинические проявления бронхиальной астмы под влиянием комплексной терапии с применением церулоплазмина. Терапевтический архив. 2016; 88 (3): 36–39. DOI: 10.17116/terarkh201688336-39.

Dupin C., Belhadi D., Guilleminault L. et al. Effectiveness and safety of dupilumab for the treatment of severe asthma in a real-life French multi-centre adult cohort. Clin. Exp. Allergy. 2020; 50 (7): 789–798. DOI: 10.1111/cea.13614.

Harrison T., Canonica G.W., Chupp G. et al. Real-world mepolizumab in the prospective severe asthma REALITI-A study: initial analysis. Eur. Respir. J. 2020; 56 (4): 2000151. DOI: 10.1183/13993003.00151-2020.

Menzella F., Ballarin A., Sartor M. et al. Comparison between clinical trials and real-world evidence studies on biologics for severe asthma. J. Int. Med. Res. 2022; 50 (11): 3000605221133689. DOI: 10.1177/03000605221133689.

Sardon-Prado O., Diaz-Garcia C., Corcuera-Elosegui P. et al. Severe asthma and biological therapies: now and the future. J. Clin. Med. 2023; 12 (18): 5846. DOI: 10.3390/jcm12185846.

Ramakrishnan S., Russell R.E.K., Mahmood H.R. et al. Treating eosinophilic exacerbations of asthma and COPD with benralizumab (ABRA): a double-blind, double-dummy, active placebo-controlled randomised trial. Lancet Respir. Med. 2025; 13 (1): 59–68. DOI: 10.1016/S2213-2600(24)00299-6.

Menzella F., Bonavia M., Bonini M. et al. Real-world experience with Benralizumab in patients with severe eosinophilic asthma: a case series. J. Asthma Allergy. 2021; 14: 149–161. DOI: 10.2147/jaa.S295676.

Carpagnano G.E., Scioscia G., Buonamico E. et al. Early effectiveness of type-2 severe asthma treatment with dupilumab in a real-life setting; a FeNO-driven choice that leads to winning management. Multidiscip. Respir. Med. 2022; 17 (1): 797. DOI: 10.4081/mrm.2022.797.

The authors declare that there are no conflicts of interest present.