Novel targets of therapy in asthma.
OBJECTIVE
The use of inhaled corticosteroids, short and long acting beta2-adrenoceptor agonists and inhibitors of leukotrienes provide most asthmatic patients with good disease control. However, none of these therapies are specifically directed to the underlying causal pathways of asthma. In this review the role of selective inhibitors of the inflammatory cascade are presented with a particular emphasis on biologics.


RESULTS
Apart from antihuman immunoglobulin E, biologics have had little impact on this disease. However, with the definition of critical pathways in driving ongoing inflammation and airway remodelling, the situation is about to change with several exciting new approaches being on the horizon. Specific cytokines that are considered central to the Th2 inflammatory response as therapeutic targets are discussed along with some entirely new approaches such as restoration of mucosal innate immunity and epithelial barrier function and the application of radiofrequency ablation of airway smooth muscle or thermal bronchoplasty.


CONCLUSIONS
What is becoming clear in filling the pipeline with new asthma therapies that treat the underlying disease causes is the need for closer working between clinical academics and industry to ensure that there is a rapid and sustained transfer of knowledge on novel targets through to their validation, proof of concept studies and clinical trials.
Holgate
Stephen T
ST
IIR Division, School of Medicine, Southampton General Hospital, Southampton, UK. sth@soton.ac.uk
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000906:Antibodies / Q000627:therapeutic use; D001249:Asthma / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D001688:Biological Products / Q000627:therapeutic use*; D016207:Cytokines / Q000378:metabolism; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008407:Mast Cells / Q000473:pathology
D000893:Anti-Inflammatory Agents; D000906:Antibodies; D001688:Biological Products; D016207:Cytokines; D007073:Immunoglobulin E