Monoclonal antibodies and other biologic agents in the treatment of asthma.
Asthma represents a syndrome of airway inflammatory diseases with complex pathology. The immunologic pathogenesis is being increasingly revealed and provides opportunity for targeted biological intervention. Current experience with immunomodulators as targeted therapy in asthma is described in this literature review. Targeted therapies have included strategies to activate dendritic cells through the 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 block IgE mediated pathways and to block TNFalpha. Omalizumab is the only biological therapy that has an approved indication in asthma at this time. An improved understanding of the heterogeneity of asthma should allow for specific targeting of different disease phenotypes specific therapies including immunomodulators.
Long
Aidan A
AA
Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA 02114, USA. aalong@mgh.harvard.edu
D000818:Animals; D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001249:Asthma / Q000276:immunology / Q000628:therapy*; D001685:Biological Factors / Q000276:immunology / Q000627:therapeutic use*; D016207:Cytokines / Q000037:antagonists & inhibitors; D003713:Dendritic Cells / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D056747:Immunomodulation; D000069444:Omalizumab; D018418:Th2 Cells / Q000187:drug effects* / Q000276:immunology; D051217:Toll-Like Receptor 9 / Q000819:agonists; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000888:Antibodies, Anti-Idiotypic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001685:Biological Factors; D016207:Cytokines; D051217:Toll-Like Receptor 9; D014409:Tumor Necrosis Factor-alpha; D000069444:Omalizumab; D007073:Immunoglobulin E