Anti-IgE and other new immunomodulation-based therapies for allergic asthma

Understanding of the cellular and molecular mechanisms in asthma has lead to the recognition of a number of potential therapeutic targets, a few of which have been evaluated in clinical studies. Parenteral administrations of both anti-IL-5 and IL-12 inhibit eosinophil recruitment to the airways, but display a lack of clinical efficacy. Interrupting the IL-4 pathway thus far has also shown disappointing results in clinical studies. Omalizumab is the first anti-IgE monoclonal antibody developed for the treatment of moderate to severe asthmatics to receive FDA approval. In a number of clinical trials treatment with omalizumab was associated with moderate improvements in a number of relevant endpoints, including the rate of occurrence of disease exacerbations. Newer DNA-based therapeutic strategies including DNA vaccination and the antisense oligonucleotides show promise but thus far have only been tested in animal models.