Immunomodulators in the treatment of asthma.
Asthma represents a syndrome of airway inflammatory diseases with a complex pathology. The immunologic pathogenesis is being increasingly revealed and provides opportunity for targeted biological intervention. This study was designed to describe current experience with immunomodulators as targeted therapy in asthma. A literature review was performed. Targeted therapies have included strategies to activate dendritic cells through the Toll-like receptor (TLR) 9 receptors, to interrupt the action of T(H)2 cytokines with cytokine blockers and monoclonal antibodies, to promote development of T(H)1 responses, to interrupt mast cell signaling, to block IgE mediated pathways, and to block TNF-alpha. Omalizumab is the only biological therapy that has an approved indication in asthma at this time. Improved understanding of the heterogeneity of asthma should allow for specific targeting of different disease phenotype-specific therapies including immunomodulators.
Long
Aidan A
AA
Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts, 02114, USA. aalong@mgh.harvard.edu
D000818:Animals; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000378:metabolism; D017277:Drug Approval; D015195:Drug Design; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology / Q000378:metabolism*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007167:Immunotherapy / Q000639:trends*; D000069444:Omalizumab; D011993:Recombinant Fusion Proteins / Q000276:immunology / Q000627:therapeutic use; D015398:Signal Transduction / Q000187:drug effects / Q000276:immunology; D051217:Toll-Like Receptor 9 / Q000378:metabolism; D014481:United States
D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D016207:Cytokines; D007155:Immunologic Factors; D011993:Recombinant Fusion Proteins; D051217:Toll-Like Receptor 9; D000069444:Omalizumab; D007073:Immunoglobulin E