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Future Treatment and Other New Biologics for Asthma

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Abstract

Various cytokines and their receptors implicated in asthma pathophysiology are new targets for future treatments for severe asthma. There are several asthma endotypes that are characterized by the presence of (1) immunoglobulin E (IgE)-mediated inflammation, (2) type 2 inflammation (T2)-high, and (3) T2-low. Endotype-based approaches are new therapeutic strategies for severe asthma. In some countries, monoclonal antibodies (mAbs) that block IgE or interleukin (IL)-5 signaling are being used to treat severe allergic asthma and severe eosinophilic asthma, respectively. Neutralizing mAbs that target the IL-4/IL-13 signaling pathway and thymic stromal lymphopoietin (TSLP) were investigated in several clinical trials involving patients with severe asthma. Drugs generated from these mAbs, such as dupilumab and tezepelumab, may be promising treatments for severe asthma patients. An antagonist of the chemoattractant receptor-homologous molecule on Th2 cells (CRTh2) is another promising drug for the treatment of asthma. Macrolides are also effective for reducing asthma exacerbation in patients with severe asthma. Together, these therapies hold promise for more effective management of asthma.

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Abbreviations

ACQ:

Asthma control questionnaire

ADCC:

Antibody-dependent cell cytotoxicity

AQLQ:

Asthma quality of life questionnaire

AZM:

Azithromycin

CRTh2:

Chemoattractant receptor-homologous molecule on Th2 cells

EGPA:

Eosinophilic granulomatosis with polyangiitis

FDA:

Food and Drug Administration

FeNO:

Fraction of exhaled nitric oxide

FEV1:

Forced expiratory volume in 1 second

ICS:

Inhaled corticosteroids

IgE:

Immunoglobulin E

IL:

Interleukin

ILC2:

Group 2 innate lymphoid cells

LABA:

Long-acting β2 agonist

LAMA:

Long-acting muscarinic antagonist

mAb:

Monoclonal antibody

OCS:

Oral corticosteroids

QOL:

Quality of life

Th2:

Type 2 helper T

TSLP:

Thymic stromal lymphopoietin

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Authors and Affiliations

  1. Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan

    Hiroshi Ohnishi & Akihito Yokoyama

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  1. Hiroshi Ohnishi
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  2. Akihito Yokoyama
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Correspondence to Hiroshi Ohnishi .

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Editors and Affiliations

  1. Department of Hematology and Respiratory Medicine, Kochi Medical School, Nankoku-shi, Kochi, Japan

    Akihito Yokoyama

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Ohnishi, H., Yokoyama, A. (2019). Future Treatment and Other New Biologics for Asthma. In: Yokoyama, A. (eds) Advances in Asthma. Respiratory Disease Series: Diagnostic Tools and Disease Managements. Springer, Singapore. https://doi.org/10.1007/978-981-13-2790-2_16

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  • DOI: https://doi.org/10.1007/978-981-13-2790-2_16

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  • Online ISBN: 978-981-13-2790-2

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