Cytokine and anti-cytokine therapy for the treatment of asthma and allergic disease.
Until recently, the only controller treatment for chronic asthma has been corticosteroids. However, identification of specific effector molecules in asthma has led to targeting of specific pathways by using cytokines and cytokine inhibitors. Administration of a monoclonal blocking antibody against IgE has been shown to be highly efficacious in severe allergic asthma, but blockade of eosinophils using anti-IL-5 monoclonal antibodies has no clinical benefit. In more severe asthma, blockade of TNF-alpha using the decoy etanercept has revealed efficacy in a small open study suggesting that Th-1 in addition to Th-2 pathways are important as the disease adopts a more severe phenotype. It is likely that asthma is not a single disease but a group of disorders which differ in the relative contribution of specific pathophysiological pathways.
Holgate
Stephen T
ST
Respiratory Cell and Molecular Biology Research Division, School of Medicine, University of Southampton, Mid-I-Level D Centre Block, (810), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK. s.holgate@soton.ac.uk
D001249:Asthma / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000037:antagonists & inhibitors* / Q000494:pharmacology / Q000627:therapeutic use*; D016503:Drug Delivery Systems; D006801:Humans; D006967:Hypersensitivity / Q000188:drug therapy*
D016207:Cytokines