Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan; Research Institute for Diseases of Old Ages, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan; Atopy (Allergy) Research Center, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
Department of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 3-1-3 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
Respir Investig. 2021 Jul;59(4):389-396. doi: 10.1016/j.resinv.2021.03.003. Epub 2021 Apr 20.
Asthma is considered a syndrome composed of heterogeneous disorders involving complex chronic airway inflammation. Patients with severe asthma, prolonged symptoms, and frequent asthma exacerbations, despite high doses of inhaled corticosteroids, may benefit from treatment with biologics. Four types of biologics are available for severe asthma, including an anti-immunoglobulin E (IgE) antibody (omalizumab), anti-interleukin (IL)-5 antibody (mepolizumab and reslizumab), anti-IL-5 receptor α antibody (benralizumab), and anti-IL-4 receptor α antibody (dupilumab). Biologics for patients with severe asthma demonstrate high therapeutic efficacy and provide significant clinical benefits, including the prevention of asthma exacerbations, alleviation of symptoms, improvement in the quality of life and respiratory function, and reduction in frequencies of hospitalization and emergency outpatient visits. This review provides an overview of the modulation of immunological features by each of the four established biologics in patients with severe allergic asthma. Given the extensive immunomodulatory effects of biologics, further analyses of their precise effects on the human immune system are warranted.
哮喘被认为是一种由涉及复杂慢性气道炎症的异质性疾病组成的综合征。尽管使用了高剂量的吸入皮质类固醇，但严重哮喘、症状持续时间长和频繁哮喘加重的患者可能受益于生物制剂治疗。有四种类型的生物制剂可用于严重哮喘，包括抗免疫球蛋白 E（IgE）抗体（奥马珠单抗）、抗白细胞介素（IL）-5 抗体（美泊利单抗和瑞利珠单抗）、抗 IL-5 受体α抗体（贝那利珠单抗）和抗 IL-4 受体α抗体（度普利尤单抗）。用于严重哮喘患者的生物制剂显示出很高的治疗效果，并提供了显著的临床益处，包括预防哮喘发作、缓解症状、改善生活质量和呼吸功能，以及减少住院和急诊就诊的次数。这篇综述概述了这四种已确立的生物制剂在严重过敏性哮喘患者中对免疫特征的调节作用。鉴于生物制剂具有广泛的免疫调节作用，有必要进一步分析它们对人体免疫系统的确切影响。
