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Eosinophils Target Therapy for Severe Asthma: Critical Points
L Brussino1,2, E Heffler3,4, C Bucca1,5
1Department of Medical Science, University of Torino, Italy.
Biomed Research International
|December 1, 2018
Summary
Severe asthma, particularly eosinophilic asthma, benefits from anti-interleukin-5 therapies targeting T2 inflammation. However, unresolved questions remain regarding treatment effectiveness and patient selection for optimal outcomes.
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Asthma is a chronic, heterogeneous respiratory disease.
- Severe asthma requires high-dose controller therapies.
- Eosinophilic asthma, a phenotype of severe asthma, is driven by T2 inflammation and interleukin-5 (IL-5).
Purpose of the Study:
- To review unresolved issues concerning anti-IL5 therapies in severe eosinophilic asthma.
- To discuss the role of IL-5 in eosinophilic asthma pathogenesis and treatment.
- To explore challenges in predicting treatment response and understanding eosinophil roles.
Main Methods:
- Review of existing literature on anti-IL5 therapies (mepolizumab, reslizumab, benralizumab).
- Analysis of data regarding exacerbation reduction in severe asthma patients.
- Discussion of unresolved questions related to airway obstruction, symptoms, and eosinophil levels.
Main Results:
- Anti-IL5 monoclonal antibodies reduce exacerbations in severe asthma patients selected by eosinophil counts.
- These therapies target IL-5, a key cytokine in eosinophil differentiation and survival.
- Unresolved issues include effects on airway obstruction, symptom control, and optimal patient selection criteria.
Conclusions:
- Anti-IL5 therapies are effective in reducing exacerbations for selected severe eosinophilic asthma patients.
- Further research is needed to fully elucidate the pathogenetic role of eosinophils and optimize treatment strategies.
- Understanding baseline eosinophil levels and their relationship to airway inflammation is crucial for personalized medicine.
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