Abstract
Asthma is a disease that consists of three main components: airway inflammation, airway hyperresponsiveness, and airway remodeling. Persistent airway inflammation leads to the destruction and degeneration of normal airway tissues, resulting in thickening of the airway wall, decreased reversibility, and increased airway hyperresponsiveness. The progression of irreversible airway narrowing and the associated increase in airway hyperresponsiveness are major factors in severe asthma. This has led to the identification of effective pharmacological targets and the recognition of several biomarkers that enable a more personalized approach to asthma. However, the efficacies of current antibody therapeutics and biomarkers are still unsatisfactory in clinical practice. The establishment of an ideal phenotype classification that will predict the response of antibody treatment is urgently needed. Here, we review recent advancements in antibody therapeutics and novel findings related to the disease process for severe asthma.
Highlights
Asthma is a disorder ordinarily characterized by allergic chronic airway inflammation.Usually, this condition is sensitive to corticosteroids and the widespread use of inhaled corticosteroids (ICS) has markedly reduced asthma emergencies
A post hoc analysis of two Randomized controlled trials (RCTs) could not identify the additional baseline characteristics associated with a response to mepolizumab [78], a retrospective review of patients who received at least 16 weeks of treatment with mepolizumab showed that the presence of nasal polyposis, a lower BMI, and a significantly lower prednisolone dose at baseline might predict a good response to mepolizumab [46]
Considerable advances have been made in antibody therapeutics for severe asthma over the last decade
Summary
Asthma is a disorder ordinarily characterized by allergic chronic airway inflammation. Society and European Respiratory Society published guidelines defining severe asthma as a condition that requires treatment with high-dose ICS, plus other long-term control medications (and/or oral corticosteroids (OCS)), or is poorly controlled regardless of these treatments [1]. These guidelines indicate that a diagnosis of severe asthma requires a correct diagnosis of asthma, confirmation of the presence of comorbidities (sinus disease, obesity, aspirin asthma, chronic obstructive pulmonary disease), and appropriate assessment of asthma control. The efficacies of current antibody therapeutics are still unsatisfactory in clinical practice This is, in part, because of the heterogeneity of severe asthma. We review recent advancements in antibody therapeutics and novel findings related to the disease process of severe asthma
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