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Open Access Biologic targeted therapy in allergic asthma

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Background:

Asthma is a heterogeneous inflammatory disease of the airway, characterized by airway hyperresponsiveness, airway obstruction, mucus hyperproduction, and airway-wall remodeling. Management of this disease involves the use of several types of therapeutic agents, each with unique indications based on the underlying cause of inflammation, clinical severity, and patient phenotype and/or endotype.

Objective:

A review of the function, clinical utility, and safety of biologic agents in the management of allergic asthma. This particular asthma phenotype involves multiple cytokines in its pathogenesis, specifically those secreted by T-helper type 2 cells.

Methods:

Medical literature was obtained from online biomedical archive searches from July 2018 to May 2019. An emphasis was placed on clinical trials that discussed biologic agents that target immunoglobulin E, interleukin (IL) 5, IL-4/IL-13, and chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTh2) pathways involved in the expression of allergic asthma.

Results:

The treatment options reviewed in this article were shown to be effective in targeting these pathways associated with allergic asthma. However, because these biologic agents are commonly prescribed in the treatment of severe asthma, many patients continue to experience asthma signs and symptoms.

Conclusion:

Future clinical trials that study these agents should focus on ideal patient selection, dosing regimens, and cost-effectiveness in the management of asthma. Ideally, comparative trials should be undertaken to assist the clinician in choosing the optimal agent.
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Keywords: CRTh2; IL-4/IL-13; IL-5; IgE; allergic asthma; biologic agents; biomarker; monoclonal antibodies; precision medicine; severe asthma

Document Type: Research Article

Affiliations: 1: From the New York Medical College, Valhalla, New York 2: Oregon State University, Corvallis, Oregon 3: Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, and 4: Division of Allergy & Clinical Immunology, Oregon Health & Science University

Publication date: December 1, 2019

This article was made available online on October 16, 2019 as a Fast Track article with title: "Targets in the use of biologics for asthma".

More about this publication?
  • The Journal of Precision Respiratory Medicine (JPRM) is a peer reviewed publication dedicated to distributing timely information regarding cutting edge advancements in the knowledge and practice of respiratory medicine. Its primary readership extends to all medical providers with an interest in respiratory diseases.

    The incorporation of the term, 'precision medicine' in its title serves to direct the journal's focus on this revolutionary approach to disease prevention and treatment that takes into account the individual differences which result from the interplay of lifestyle, environment and human biology/genetics.

    JPRM seeks to publish articles characterized by both a predominant clinical focus and by having the potential to directly impact the quality of patient care. JPRM welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Pulmonary Conference (EPC) JPRM will publish content from EPC poster sessions as well as review articles derived from EPC lectures.

    Click on the fast track tab below to access new pre-publication articles.
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