Ntontsi Polyxeni, Papathanassiou Evgenia, Loukides Stelios, Bakakos Petros, Hillas Georgios
a 2nd Respiratory Medicine Department , National and Kapodistrian University of Athens, Medical School, Attikon Hospital , Athens , Greece.
b 1st Respiratory Medicine Department , National and Kapodistrian University of Athens, Medical School, Sotiria Chest Hospital , Athens , Greece.
Expert Opin Investig Drugs. 2018 Feb;27(2):179-186. doi: 10.1080/13543784.2018.1427729. Epub 2018 Jan 19.
The identification of patients with severe asthma who will benefit from a personalized management approach remains an unmet need. Interleukin-13 (IL-13) is a cytokine possessing a significant role in asthma pathogenesis and progression of disease. Humanised monoclonal antibodies against IL-13 and IL-13 and IL-4 receptors are mainly proposed as add-on therapy in patients with T2-high inflammation with uncontrolled asthma despite maximum therapy.
The role of IL-13 in airway inflammation in severe asthma, the targeted anti-IL-13 therapies and biomarkers that predict response to anti-IL-13 treatment are discussed.
New effective individualized therapies in severe asthma are urgently needed to block specific inflammatory pathways using monoclonal antibodies. Studies on anti-IL-13 therapies showed that asthmatic patients could benefit from this novel targeted therapy as far as lung function and exacerbation rate are concerned. T2-high and especially periostin-high groups of asthmatics with moderate-to-severe uncontrolled asthma seem to compose the group that could benefit from anti-IL-13 therapy. Targeting IL-13 alone may not be sufficient to achieve asthma control. Inhibition of IL-13 and IL-4 with mabs may be more encouraging and patients will probably have additional benefits from these therapeutic interventions because of IL-13/IL-4 overlapping actions in asthma pathophysiology.
确定哪些重度哮喘患者将从个性化管理方法中获益仍是一项未满足的需求。白细胞介素-13（IL-13）是一种在哮喘发病机制和疾病进展中起重要作用的细胞因子。抗IL-13以及抗IL-13和IL-4受体的人源化单克隆抗体主要被提议作为尽管接受了最大程度治疗但仍有T2高炎症且哮喘未得到控制的患者的附加治疗。
讨论了IL-13在重度哮喘气道炎症中的作用、靶向抗IL-13疗法以及预测抗IL-13治疗反应的生物标志物。
迫切需要新的有效的重度哮喘个体化疗法，以使用单克隆抗体阻断特定的炎症途径。抗IL-13疗法的研究表明，就肺功能和加重率而言，哮喘患者可从这种新型靶向治疗中获益。T2高尤其是骨膜蛋白高的中重度未控制哮喘患者群体似乎是可从抗IL-13治疗中获益的群体。仅靶向IL-13可能不足以实现哮喘控制。用单克隆抗体抑制IL-13和IL-4可能更令人鼓舞，并且由于IL-13/IL-4在哮喘病理生理学中的重叠作用，患者可能会从这些治疗干预中获得额外益处。
