Abstract
Severe asthma is a heterogeneous, complex and chronic disease widespread in the pediatric population. According to the recent findings about the different endotypes of asthma in children, each one characterized by specific intracellular molecular pathways, several innovative biologic therapies have been developed. Due to their precise ability to target specific inflammatory type 2 mediators, biologics have revolutionized the care of chronic allergic diseases in the pediatric and adult population. In this review, we aim to provide the latest evidence about the use, indications, efficacy and safety of biologic therapies to treat severe asthma in children and adolescents.
Highlights
Monoclonal antibodies are monovalent antibodies binding to the same epitope and generating from a single B-lymphocyte clone [1].Each antibody is composed of two identical heavy chains and two identical light chains assembled to constitute three functional domains: a crystallizable fragment (Fc) and two antigen-binding fragments (Fabs)
Found a reduction of about half of cases who used oral corticosteroids (OCS) in the Mepolizumab group compared to the control group involving patients over 16 years of age with severe eosinophilic asthma requiring a daily intake of OCS despite the use of high–dose inhaled corticosteroids (ICS) [59]
The characterization of phenotype and, recently, of endotype have allowed the development of several biologic drugs targeting specific intracellular pathways of the inflammatory allergic cascade
Summary
Monoclonal antibodies (mAbs) are monovalent antibodies binding to the same epitope and generating from a single B-lymphocyte clone [1]. Transfected mAbs-producing cells are selected in cultures that allow survival and growth only of cell clones expressing the marker gene product. These clones are transferred to a second culture medium to produce clonal populations. The suffix used in the nomenclature of monoclonal antibodies indicates whether they are murine (–omab), chimeric (–ximab), humanized (–zumab) or fully human (–umab) [15]. Their activity was first against specific immune cells, such as CD4 or CD3 lymphocytes, to avoid rejection after solid organ transplantation. The aim of this review is to provide a clinical guide on the mAbs used in children with severe asthma, focusing on the main characteristics in terms of applications, safety, efficacy, limitations and future directions in clinical practice
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