慢阻肺生物制剂治疗：从“精准分型”到 “临床实践”的突破与挑战

Biological Agents for COPD Treatment: Breakthroughs and Challenges from “Precision Phenotyping” to “Clinical Practice”

摘要: 慢性阻塞性肺疾病(COPD)作为全球第三大致死性疾病，传统治疗模式已难以全方位满足所有患者的临床需求。近年来，基于炎症内型的生物标志物指导下的精准治疗，为慢阻肺的治疗带来了新方案。本文系统综述了生物制剂在慢阻肺治疗中的应用现状，着重分析从分子分型到临床实践的转化路径。以血嗜酸粒细胞为导向的2型炎症靶向治疗已取得显著突破，度普利尤单抗和美泊利珠单抗相继获得监管机构批准，标志着慢阻肺治疗正式步入“生物时代”。目前，非2型炎症的生物标志物存在一定局限性，生物标志物的优化、安全性等问题亟待解决。因此，本文将慢阻肺生物制剂治疗从“精准分型”到“临床实践”的突破与挑战进行综述，为此病的生物标志物和治疗提供参考。

Abstract: Chronic Obstructive Pulmonary Disease (COPD) ranks as the third leading cause of death globally, and traditional treatment models have struggled to fully meet the clinical needs of all patients. In recent years, precision therapy guided by biomarkers of inflammation-based phenotypes has brought new solutions to the treatment of COPD. This article systematically reviews the current application of biologics in the treatment of COPD, focusing on analyzing the translational pathway from molecular phenotyping to clinical practice. Targeted therapy for type 2 inflammation guided by eosinophils has achieved significant breakthroughs, with duraprilumab and mepolizumab being approved by regulatory authorities, marking the official entry of COPD treatment into the “biological era”. Currently, biomarkers for non-type 2 inflammation exhibit certain limitations, and issues such as biomarker optimization and safety urgently need to be addressed. Therefore, this article reviews the breakthroughs and challenges in the treatment of COPD with biologics, from “precise phenotyping” to “clinical practice”, providing a reference for biomarkers and treatment of this disease.