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Related Concept Videos

Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs01:25

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Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
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Asthma is a chronic pulmonary condition involving inflammation of the airways, hyper-reactivity, and reversible obstruction of the airways. This condition can significantly impact a person's quality of life, making breathing difficult and leading to distressing symptoms.
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Asthma-II: Pathophysiology and Classification01:26

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Asthma is a prevalent chronic respiratory condition marked by inflammation and hyperresponsiveness of the airways. Its pathophysiology involves complex interactions among inflammatory pathways, immune responses, and neural mechanisms.
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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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Biologics in severe asthma.

Corrado Pelaia1, Giulia Pelaia2, Claudia Crimi3

  • 1Department of Health Sciences, The Magna Græcia University of Catanzaro, Catanzaro, Italy - pelaia.corrado@gmail.com.

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Biological therapies target specific pathways in severe asthma, offering tailored treatments for type-2 airway inflammation. These advanced treatments, including monoclonal antibodies, aim for better asthma control by addressing underlying disease mechanisms.

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Area of Science:

  • Immunology
  • Pulmonology
  • Pharmacology

Background:

  • Asthma is a chronic airway disease characterized by variable airflow limitation and bronchial hyperresponsiveness.
  • Asthma phenotypes are driven by distinct inflammatory endotypes involving specific cellular and molecular mechanisms.
  • Severe asthma presents complex pathobiology, with key molecules like immunoglobulin E (IgE) and cytokines as therapeutic targets.

Purpose of the Study:

  • To review current and emerging biological treatments for severe asthma.
  • To highlight how these therapies target specific molecular pathways involved in type-2 airway inflammation.
  • To emphasize the importance of phenotype/endotype-driven treatment selection for effective asthma management.

Main Methods:

  • Review of registered monoclonal antibodies used in severe asthma treatment.
  • Discussion of biological therapies targeting IgE, IL-5, IL-5 receptor, IL-4/IL-13 receptors, IL-33, and TSLP.
  • Exploration of ongoing clinical trials for novel biological agents.

Main Results:

  • Registered biologics like omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab effectively target key pathways in type-2 inflammation.
  • Omalizumab targets IgE; mepolizumab and reslizumab target IL-5; benralizumab targets the IL-5 receptor; dupilumab targets IL-4/IL-13 receptors.
  • Emerging therapies targeting IL-33 and TSLP are under evaluation for safety and efficacy.

Conclusions:

  • Biological therapies offer targeted approaches for severe asthma based on its underlying endotype.
  • Personalized treatment strategies utilizing these biologics can lead to effective control of difficult-to-treat type-2 asthma.
  • The landscape of severe asthma treatment is evolving with new biological agents offering improved patient outcomes.