304 Ch 303. Asthma

氣喘 = 慢性 airway inflammation + bronchial hyperresponsiveness + variable airflow limitation；phenotypes / endotypes 分多種：T2-high (eosinophilic, allergic + non-allergic)、T2-low (neutrophilic, paucigranulocytic)；GINA 2024 + 2025 framework 強調 all asthma should have ICS-containing reliever (low-dose ICS-formoterol)，不再單獨用 SABA；stepwise management：Step 1 (as-needed ICS-formoterol) → Step 5 (high-dose ICS-LABA + add-on)；biologics 革命：anti-IgE (omalizumab)、anti-IL-5 (mepolizumab, reslizumab)、anti-IL-5R (benralizumab)、anti-IL-4/13 (dupilumab)、anti-TSLP (tezepelumab — 2022, broad efficacy)；severe asthma 處理流程：phenotype assessment + biologic selection；asthma exacerbation：SABA + ICS + oral steroids + escalation；special populations：occupational asthma (RADS)、aspirin-exacerbated respiratory disease (AERD)、exercise-induced bronchospasm (EIB)、cough-variant asthma、pregnancy + asthma；2024 biomarkers：blood eosinophils、FeNO、IgE、periostin、DPP-4。