Anda Suárez Pablo Xavier, Romero Uziel Márquez, Méndez Nayely García, Rengel Chalco María José, Vivas Monzón María Alejandra, Zavala Gama Ciro Gonzalo
Primary and Outpatient Care, Universidad de Las Américas, Quito, ECU.
Intensive Care - Emergency, Hospital de Alta Especialidad de Veracruz, Veracruz, MEX.
Cureus. 2025 May 7;17(5):e83629. doi: 10.7759/cureus.83629. eCollection 2025 May.
This review aims to analyze biologic treatments for pediatric asthma, along with their effects on T2-high inflammation, together with outcomes of omalizumab, mepolizumab, and dupilumab. This review examined recent biomarker advancements, together with endotype patterns, while analyzing early treatment opportunities that might transform asthma's natural course. In conclusion, the advancement in biologic therapies is offering significant progress for personalized severe asthma treatment among pediatrics, especially for the T2-high endotype. Biologics such as omalizumab, mepolizumab, dupilumab, benralizumab, and tezepelumab have been reported to reduce severe asthma exacerbations, with reassuring short-term safety profiles among children and adolescents (pediatrics). However, the treatment efficacy of these biologics is limited for T2-low and non-T2 asthma endotypes, emphasizing the need for new biologic therapies that target these endotypes. Literature review also highlights the emerging treatment regimens for non-T2 endotypes, such as tezepelumab, ecleralimab, and astegolimab (IL-33), which influence both T2 and non-T2 pathways. The integration of precision medicine and multi-omics data specific to patients is not only providing promising results, but also helping to refine patient selection and patient-specific treatment. Furthermore, the identification of novel predictive biomarkers through advanced omics methods is essential for a more personalized approach. Ultimately, the continued advancement and strategic implementation of biologic therapies hold the potential to revolutionize the management of severe pediatric asthma, leading to reduced exacerbations and corticosteroid use, improved quality of life, and more precise treatment strategies tailored to individual patient profiles. Moreover, future research should continue to address the challenges related to long-term safety, cost-effectiveness, and equitable access, which are vital to realizing the true potential of biologic therapies in treating pediatric asthma.
本综述旨在分析儿童哮喘的生物治疗方法及其对2型高炎症的影响，以及奥马珠单抗、美泊利单抗和度普利尤单抗的治疗效果。本综述研究了近期生物标志物的进展以及内型模式，同时分析了可能改变哮喘自然病程的早期治疗机会。总之，生物治疗的进展为儿科个性化重症哮喘治疗带来了显著进展，尤其是对于2型高内型。据报道，奥马珠单抗、美泊利单抗、度普利尤单抗、贝那利珠单抗和tezepelumab等生物制剂可减少重症哮喘发作，在儿童和青少年（儿科患者）中具有令人放心的短期安全性。然而，这些生物制剂对2型低和非2型哮喘内型的治疗效果有限，这凸显了针对这些内型的新型生物治疗的必要性。文献综述还强调了非2型内型的新兴治疗方案，如tezepelumab、ecleralimab和astegolimab（IL-33），它们影响2型和非2型途径。将精准医学与患者特异性多组学数据相结合不仅产生了有前景的结果，还有助于优化患者选择和个性化治疗。此外，通过先进的组学方法识别新型预测生物标志物对于更个性化的治疗方法至关重要。最终，生物治疗的持续进展和战略实施有可能彻底改变重症儿童哮喘的管理，减少发作次数和皮质类固醇的使用，提高生活质量，并制定更精确的针对个体患者情况的治疗策略。此外，未来的研究应继续应对与长期安全性、成本效益和公平可及性相关的挑战，这些对于实现生物治疗在治疗儿童哮喘方面的真正潜力至关重要。
