Department of Medicine, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan.
Allergy Asthma Clin Immunol. 2005 Mar 15;1(1):34-41. doi: 10.1186/1710-1492-1-1-34.
Numerous recombinant therapies are being investigated for the treatment of asthma. This report reviews the current status of several of these novel agents. Anti-immunoglobulin (Ig)E (omalizumab, Xolair) markedly inhibits all aspects of the allergen challenge in subjects who have reduction of free serum IgE to undetectable levels. Several clinical studies in atopic asthma have demonstrated benefit by improved symptoms and lung function and a reduction in corticosteroid requirements. Early use in atopic asthmatics may be even more effective. Several approaches target interleukin (IL)-4. Soluble IL-4 receptor has been shown to effectively replace inhaled corticosteroid; further studies are under way. Recombinant anti-IL-5 and recombinant IL-12 inhibit blood and sputum eosinophils and allergen-induced eosinophilia without any effect on airway responsiveness, allergen-induced airway responses, or allergen-induced airway hyperresponsiveness. Efalizumab, a recombinant antibody that inhibits lymphocyte trafficking, is effective in psoriasis. A bronchoprovocation study showed a reduction in allergen-induced late asthmatic response and allergen-induced eosinophilia, which suggests that it should be effective in clinical asthma. These exciting novel therapies provide not only promise of new therapies for asthma but also valuable tools for investigation of asthma mechanisms.
许多重组治疗方法正在被研究用于哮喘的治疗。本报告综述了几种新型药物的现状。抗免疫球蛋白（Ig）E（奥马珠单抗，Xolair）显著抑制了变应原刺激下所有方面的反应，使血清游离 IgE 降低至无法检测的水平。在变应性哮喘的几项临床研究中，改善症状和肺功能以及减少皮质类固醇需求均显示出获益。在变应性哮喘患者中的早期使用可能更为有效。有几种方法针对白细胞介素（IL）-4。已证明可溶性 IL-4 受体可有效替代吸入皮质类固醇；正在进行进一步的研究。重组抗 IL-5 和重组 IL-12 抑制血液和痰中的嗜酸性粒细胞以及变应原诱导的嗜酸性粒细胞增多，而对气道反应性、变应原诱导的气道反应或变应原诱导的气道高反应性没有任何影响。依那西普，一种抑制淋巴细胞迁移的重组抗体，对银屑病有效。一项支气管激发研究显示，它可减少变应原诱导的迟发性哮喘反应和变应原诱导的嗜酸性粒细胞增多，这表明它在临床哮喘中应该是有效的。这些令人兴奋的新型疗法不仅为哮喘提供了新的治疗方法的希望，而且为哮喘机制的研究提供了有价值的工具。
