Bagnasco Diego, Testino Elisa, Nicola Stefania, Melissari Laura, Russo Maria, Canevari Rikki Frank, Brussino Luisa, Passalacqua Giovanni
Allergy and Respiratory Diseases, Department of Internal Medicine (DIMI), University of Genoa, 16132 Genoa, Italy.
IRCCS Policlinico San Martino, 16132 Genoa, Italy.
J Pers Med. 2022 Apr 7;12(4):593. doi: 10.3390/jpm12040593.
Asthma is a disease with high incidence and prevalence, and its severe form accounts for approximately 10% of asthmatics. Over the last decade, the increasing knowledge of the mechanisms underlying the disease allowed the development of biological drugs capable of sufficiently controlling symptoms and reducing the use of systemic steroids. The best-known mechanisms are those pertaining to type 2 inflammation, for which drugs were developed and studied. Those biological treatments affect crucial points of bronchial inflammation. Among the mechanisms explored, there were IgE (Omalizumab), interleukin 5 (Mepolizumab and Reslizumab), interleukin 5 receptor alpha (Benralizumab) and interleukin 4/13 receptor (Dupilumab). Under investigation and expected to be soon commercialized is the monoclonal antibody blocking the thymic stromal lymphopoietin (Tezepelumab). Seemingly under study and promising, are anti-interleukin-33 (itepekimab) and anti-suppressor of tumorigenicity-2 (astegolimab). With this study, we want to provide an overview of these drugs, paying particular attention to their mechanism of action, the main endpoints reached in clinical trials, the main results obtained in real life and some unclear points regarding their usage.
哮喘是一种发病率和患病率都很高的疾病，其严重形式约占哮喘患者的10%。在过去十年中，对该疾病潜在机制的认识不断增加，使得能够充分控制症状并减少全身类固醇使用的生物药物得以开发。最广为人知的机制是与2型炎症相关的机制，针对这些机制开发并研究了相关药物。这些生物治疗影响支气管炎症的关键点。在探索的机制中，有免疫球蛋白E（奥马珠单抗）、白细胞介素5（美泊利单抗和瑞利珠单抗）、白细胞介素5受体α（贝那利珠单抗）和白细胞介素4/13受体（度普利尤单抗）。正在研究且有望很快商业化的是阻断胸腺基质淋巴细胞生成素的单克隆抗体（tezepelumab）。似乎正在研究且有前景的是抗白细胞介素-33（itepekimab）和抗致瘤性-2抑制因子（astegolimab）。通过本研究，我们希望对这些药物进行概述，特别关注它们的作用机制、临床试验中达到的主要终点、在现实生活中获得的主要结果以及关于其使用的一些不明确之处。
