Maselli Diego Jose, Velez Maria Ines, Rogers Linda
Department of Medicine, Division of Pulmonary Diseases and Critical Care, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Pulmonary, Critical Care, and Sleep Division, Mount Sinai-National Jewish Health Respiratory Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Asthma Allergy. 2016 Aug 31;9:155-62. doi: 10.2147/JAA.S94164. eCollection 2016.
Interleukin-5, an important cytokine in the pathophysiology of asthma, participates in terminal maturation and increases chemotaxis, endothelial adhesion, and activation of eosinophils. Blockade of interleukin-5 activity with monoclonal antibodies have been successful in decreasing eosinophil counts. Reslizumab, a monoclonal antibody that targets interleukin-5, has been studied for the treatment of severe asthma. Several studies have shown that reslizumab can effectively treat severe asthma with an eosinophilic phenotype. Compared to placebo, patients treated with reslizumab had a reduction in the rates of asthma exacerbations and experienced improvement in FEV1 and asthma control questionnaires scores as early as 4 weeks after the therapy was initiated. Reslizumab was not effective in various asthma outcomes in patients without eosinophilia. The adverse events reported were similar in both treatment and placebo groups. Patients should be observed immediately after treatment because anaphylaxis may occur rarely (0.3%) after exposure to reslizumab. Future surveillance studies are still needed to establish the risks of malignancy and safety during pregnancy.
白细胞介素-5是哮喘病理生理学中的一种重要细胞因子,参与终末成熟并增加趋化性、内皮黏附以及嗜酸性粒细胞的活化。用单克隆抗体阻断白细胞介素-5的活性已成功降低了嗜酸性粒细胞计数。瑞利珠单抗是一种靶向白细胞介素-5的单克隆抗体,已被研究用于治疗重度哮喘。多项研究表明,瑞利珠单抗可有效治疗具有嗜酸性粒细胞表型的重度哮喘。与安慰剂相比,接受瑞利珠单抗治疗的患者哮喘加重率降低,并且早在治疗开始后4周,其第1秒用力呼气容积(FEV1)和哮喘控制问卷评分就有所改善。瑞利珠单抗对无嗜酸性粒细胞增多的患者的各种哮喘结局无效。治疗组和安慰剂组报告的不良事件相似。治疗后应立即观察患者,因为接触瑞利珠单抗后可能很少发生过敏反应(0.3%)。未来仍需要进行监测研究以确定恶性肿瘤风险和孕期安全性。