Targeting eosinophils: severe asthma and beyond

Drugs in Context

article

Marco Caminati¹  Francesco Menzella³  Lucia Guidolin²  Gianenrico Senna¹ 

[1] Asthma Center and Allergy Unit, Verona University Hospital;Department of Medicine, School of Specialization in Allergy and Clinical Immunology, University of Verona;Department of Medical Specialties

关键词: ABPA;    benralizumab;    EGPA;    eosinophilic esophagitis;    eosinophilic inflammation;    mepolizumab;    reslizumab;    severeasthma.;   

DOI  :  10.7573/dic.212587

学科分类：社会科学、人文和艺术（综合）

来源: C S F Medical Communications Ltd.

【 摘 要 】

Recent research in the field of bronchial asthma has mainlyfocused on eosinophilic disease phenotype. Several trialsproved the efficacy and safety profile of eosinophils andinterleukin (IL)-5 targeting molecules, currently approvedfor severe asthma and available on the market. They includemepolizumab and reslizumab, IL-5 blocking molecules, andbenralizumab, targeting the IL-5 receptor and eliciting aNK cell-mediated antibody-dependent cellular cytotoxicityagainst eosinophils. Eosinophilic inflammation represents thecommon pathophysiological background of several conditions,providing the rationale for the use of the same biologicsbeyond asthma. Although with different evidence grade, fromclinical trials to case reports, anti-IL-5 biologics have beeninvestigated in eosinophilic granulomatosis with polyangitis,allergic bronchopulmonary aspergillosis, chronic eosinophilicpneumonia, nasal polyposis, hypereosinophilic syndrome, andeosinophilic esophagitis.However, non-negligible differences between asthma and othereosinophilic diseases, particularly in eosinophils homing (bloodand/or tissues), target organs and thus clinical features, probablyaccount for the different response to the same drug in differentclinical conditions and highlights the need for tailoring thetherapeutic approach by modulating the drug dose and/or bycombination therapy with multiple drugs.The optimal safety and tolerability profile of anti-IL-5 drugswarrants further and larger experimental and real-lifeinvestigations, which are needed especially in the field of nonasthma eosinophilic diseases.This review aims at summarizing the rationale for the useof biologics in eosinophilic diseases and their mechanismsof action. The current efficacy and safety evidence abouteosinophils and IL-5 targeting molecules in asthma and ineosinophilic conditions beyond bronchi is also discussed.

【 授权许可】

CC BY-NC-ND