Clinic of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Łódz, Poland.
Front Immunol. 2020 Jun 18;11:1134. doi: 10.3389/fimmu.2020.01134. eCollection 2020.
Asthma is a chronic and heterogenic respiratory tract disorder with a high global prevalence. The underlying chronic inflammatory process and airway remodeling (AR) contribute to the symptomatology of the disease. The most severely ill asthma patients may now be treated using a variety of monoclonal antibodies aiming key inflammatory cytokines involved in asthma pathogenesis. Although clinical data shows much beneficial effects of biological therapies in terms of reduction of exacerbation rates, improvement of lung functions, asthma control and patients' quality of life, little is known on the effects of these monoclonal antibodies on AR-a key clinical trait of long-term asthma management. In this review, the authors summarize the data on the proven effects of monoclonal antibodies in asthma on AR. To date, in terms of reversing AR, the mostly studied was omalizumab. However, some studies also addressed this clinical issue in context of other severe asthma biological therapies (mepolizumab, benralizumab, tralokinumab). Still, data on effects of particular biological therapies on AR in severe asthma are incomplete and require further studies. According to the American Thoracic Society research recommendations, future research shall focus on AR in asthma and improve drugs targeting AR, including the available and future monoclonal antibodies.
哮喘是一种慢性异质性呼吸道疾病，具有很高的全球患病率。潜在的慢性炎症过程和气道重塑（AR）导致了疾病的症状。现在，最严重的哮喘患者可以使用多种针对哮喘发病机制中关键炎症细胞因子的单克隆抗体进行治疗。尽管临床数据显示生物疗法在降低恶化率、改善肺功能、哮喘控制和患者生活质量方面具有显著的疗效，但对于这些单克隆抗体对 AR 的影响知之甚少，AR 是长期哮喘管理的一个关键临床特征。在这篇综述中，作者总结了已证实的单克隆抗体在哮喘对 AR 影响方面的数据。迄今为止，在逆转 AR 方面，研究最多的是奥马珠单抗。然而，一些研究也在其他严重哮喘生物疗法（美泊利珠单抗、贝那利珠单抗、特瑞普利单抗）的背景下探讨了这一临床问题。然而，关于特定生物疗法对严重哮喘 AR 的影响的数据并不完整，需要进一步研究。根据美国胸科学会的研究建议，未来的研究应集中在哮喘中的 AR 上，并改善针对 AR 的药物，包括现有的和未来的单克隆抗体。
