Walsh Garry M
Immunity, Infection and Inflammation Programme, School of Medicine, Medical Sciences and Nutrition Institute of Medical Sciences University of Aberdeen, Foresterhill, Aberdeen, UK.
Curr Opin Otolaryngol Head Neck Surg. 2017 Jun;25(3):231-234. doi: 10.1097/MOO.0000000000000352.
The development of monoclonal antibody-based biologics targeted at inhibition of the Th2 cytokines interleukin-4, interleukin-5 and interleukin-13 represent potentially effective treatments for asthma and allergic diseases. This short review is based on English-language original articles in PubMed or MedLine that reported significant clinical findings on the evidence demonstrating the effectiveness or otherwise of the targeting of interleukin-4, interleukin-5 or interleukin-13 in asthma or allergic disease.
Asthma exhibits marked heterogeneity both clinically and at the molecular phenotypic level requiring specifically targeted treatments to block the key pathways of the disease. It is becoming apparent that significant clinical effects with anticytokine-based biologic therapies are more likely in carefully selected patient populations that take asthma phenotypes into account. Biologics aimed at interleukin-4/13, interleukin-5 or immunoglobulin E are potentially effective treatments for patients with difficult to treat allergic disease. The development of reproducible and straightforward discriminatory biomarkers may aid identification of those patients most likely to benefit from treatment with these expensive interventions.
Overall these biologics-based therapies are effective treatments for difficult to treat asthma and allergic disease with a safety profile comparable with placebo in the majority of published studies.
开发针对抑制Th2细胞因子白细胞介素-4、白细胞介素-5和白细胞介素-13的单克隆抗体类生物制剂,可能是治疗哮喘和过敏性疾病的有效方法。本简短综述基于PubMed或MedLine上的英文原创文章,这些文章报道了关于白细胞介素-4、白细胞介素-5或白细胞介素-13靶向治疗哮喘或过敏性疾病有效性的显著临床研究结果。
哮喘在临床和分子表型水平上均表现出显著的异质性,需要针对性的治疗来阻断疾病的关键途径。越来越明显的是,基于抗细胞因子的生物治疗在仔细选择的、考虑哮喘表型的患者群体中更有可能产生显著的临床效果。针对白细胞介素-4/13、白细胞介素-5或免疫球蛋白E的生物制剂可能是治疗难治性过敏性疾病患者的有效方法。开发可重复且直接的鉴别生物标志物可能有助于识别最有可能从这些昂贵干预措施治疗中获益的患者。
总体而言,在大多数已发表的研究中,这些基于生物制剂的疗法是治疗难治性哮喘和过敏性疾病的有效方法,其安全性与安慰剂相当。