Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab

Asthma is a heterogeneous respiratory disease characterized by usually reversible bronchial obstruction, which is clinically expressed by different phenotypes driven by complex pathobiological mechanisms (endotypes). In recent years several molecular effectors and signaling pathways have emerged as...

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Main Author: Shih-Lung Cheng
Format: Article
Language:English
Published: MDPI AG 2021-07-01
Series:Life
Subjects:
Online Access:https://www.mdpi.com/2075-1729/11/8/744
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author Shih-Lung Cheng
author_facet Shih-Lung Cheng
author_sort Shih-Lung Cheng
collection DOAJ
description Asthma is a heterogeneous respiratory disease characterized by usually reversible bronchial obstruction, which is clinically expressed by different phenotypes driven by complex pathobiological mechanisms (endotypes). In recent years several molecular effectors and signaling pathways have emerged as suitable targets for biological therapies of severe asthma, refractory to standard treatments. Indeed, various therapeutic mono-clonal antibodies currently allow one to intercept at different levels the chain of pathogenic events leading to type 2 (T2) airway inflammation. Pro-allergic immunoglobulin E (IgE) is the first molecule against which an anti-asthma monoclonal antibody (omalizumab) was developed; today other targets are successfully being exploited by biological treatments for severe asthma. In particular, pro-eosinophilic interleukin 5 (IL-5) can be targeted by mepolizumab or reslizumab, whereas benralizumab is a selective blocker of IL-5 receptor, and IL-4 and IL-13 can be targeted by dupilumab. Besides these drugs, which are already available in medical practice, other biologics are under clinical development such as those targeting innate cytokines, including the alarmin thymic stromal lymphopoietin (TSLP), which plays a key role in the pathogenesis of type 2 asthma. Therefore, ongoing and future biological therapies are significantly changing severe asthma management on a global level. These new therapeutic options make it possible to implement phenotype/endotype-specific treatments, which are delineating personalized approaches precisely addressing the individual traits of asthma pathobiology. The aim of the study is to review the immunopathology and treatment efficacy for severe asthma and focused on new biological agents with benralizumab (anti-IL-5) and tezepelumab (anti-TSLP).
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spelling doaj.art-54428254fa0f4906984f17777c8096892023-11-22T08:22:15ZengMDPI AGLife2075-17292021-07-0111874410.3390/life11080744Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and TezepelumabShih-Lung Cheng0Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei 10042, TaiwanAsthma is a heterogeneous respiratory disease characterized by usually reversible bronchial obstruction, which is clinically expressed by different phenotypes driven by complex pathobiological mechanisms (endotypes). In recent years several molecular effectors and signaling pathways have emerged as suitable targets for biological therapies of severe asthma, refractory to standard treatments. Indeed, various therapeutic mono-clonal antibodies currently allow one to intercept at different levels the chain of pathogenic events leading to type 2 (T2) airway inflammation. Pro-allergic immunoglobulin E (IgE) is the first molecule against which an anti-asthma monoclonal antibody (omalizumab) was developed; today other targets are successfully being exploited by biological treatments for severe asthma. In particular, pro-eosinophilic interleukin 5 (IL-5) can be targeted by mepolizumab or reslizumab, whereas benralizumab is a selective blocker of IL-5 receptor, and IL-4 and IL-13 can be targeted by dupilumab. Besides these drugs, which are already available in medical practice, other biologics are under clinical development such as those targeting innate cytokines, including the alarmin thymic stromal lymphopoietin (TSLP), which plays a key role in the pathogenesis of type 2 asthma. Therefore, ongoing and future biological therapies are significantly changing severe asthma management on a global level. These new therapeutic options make it possible to implement phenotype/endotype-specific treatments, which are delineating personalized approaches precisely addressing the individual traits of asthma pathobiology. The aim of the study is to review the immunopathology and treatment efficacy for severe asthma and focused on new biological agents with benralizumab (anti-IL-5) and tezepelumab (anti-TSLP).https://www.mdpi.com/2075-1729/11/8/744severe asthmainterleukin-5thymic stromal lymphopoietin
spellingShingle Shih-Lung Cheng
Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab
Life
severe asthma
interleukin-5
thymic stromal lymphopoietin
title Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab
title_full Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab
title_fullStr Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab
title_full_unstemmed Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab
title_short Molecular Targets for Biological Therapies of Severe Asthma: Focus on Benralizumab and Tezepelumab
title_sort molecular targets for biological therapies of severe asthma focus on benralizumab and tezepelumab
topic severe asthma
interleukin-5
thymic stromal lymphopoietin
url https://www.mdpi.com/2075-1729/11/8/744
work_keys_str_mv AT shihlungcheng moleculartargetsforbiologicaltherapiesofsevereasthmafocusonbenralizumabandtezepelumab