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Biologics or immunotherapeutics for asthma?
1Priority Research Centre for Healthy Lungs, Department of Microbiology and Immunology, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Hunter Medical Research Institute, Australia.
Pharmacological Research
|April 11, 2020
Summary
Asthma is a complex lung disease with distinct subtypes. Targeting type 2 (T2) inflammatory pathways with new biologics shows promise for severe asthma, but further research is needed for comprehensive treatment.
Area of Science:
- Pulmonology
- Immunology
- Pharmacology
Background:
- Asthma is a heterogeneous inflammatory lung disease with distinct cellular and molecular subtypes, including eosinophilic (T2), neutrophilic (T1), mixed, and paucigranulocytic.
- Current asthma treatments like steroids and bronchodilators offer limited efficacy, especially during exacerbations.
- Key asthma features such as eosinophil activity, bronchoconstriction, and mucus production are regulated by type 2 (T2) cytokines (IL-4, IL-5, IL-13).
Purpose of the Study:
- To review the effectiveness of targeting T2 inflammatory pathways in asthma.
- To explore emerging therapeutic approaches for asthma management.
- To identify future directions for asthma treatment interventions.
Main Methods:
- Review of current literature on asthma pathophysiology and treatment.
- Analysis of the role of T2 cytokines and their signaling pathways.
- Evaluation of existing and novel biologic therapies targeting T2 pathways.
Main Results:
- New biologic therapies targeting IL-5 and IL-4/13 pathways have shown efficacy in treating eosinophilic asthma exacerbations.
- Targeting T2 pathways offers a promising strategy for severe asthma.
- Challenges remain in treating all asthma exacerbations, potentially due to other inflammatory cells like neutrophils.
Conclusions:
- Targeting T2 inflammatory pathways represents a significant advancement in treating severe eosinophilic asthma.
- Further research is needed to address limitations in current therapies and explore new therapeutic targets, including non-T2 pathways.
- Comprehensive treatment strategies may require addressing multiple inflammatory pathways involved in asthma pathogenesis.
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