Abstract
The IL-4 and IL-13 cytokine pathways play integral roles in stimulating IgE inflammation, with the IL-4 cytokine being a major cytokine in the etiology of thunderstorm asthma, atopic dermatitis, and allergic rhinitis. The increasing prevalence of thunderstorm asthma in the younger population and the lessening efficacy of corticosteroids and other anti-inflammatories has created a need for more effective pharmaceuticals. This review summarizes the IL-4 and IL-13 pathways while highlighting and discussing the current pathway inhibitors aimed at treating thunderstorm asthma and atopic dermatitis, as well as the potential efficacy of peptide therapeutics in this field.
Highlights
Allergies are a worldwide issue, with approximately 20% of the global population suffering from allergy-caused symptoms including rashes, runny nose, and life-threatening breathing problems [1].This creates a gargantuan burden on global healthcare systems and lowers the quality of life for patients [1]
The overwhelming majority of inhibitory therapeutics currently being investigated for IL-4 pathway inhibition are immunotherapeutics that involve the use of large, monoclonal antibody molecules targeting either the IL-4 or IL-13 cytokines or their corresponding receptors
While targeting the same receptor or cytokine, these antibodies display different efficacy among patient groups, which can be attributed to small genetic variations, such as the 30 genetic alteration discovered by the researchers studying lebrikizumab [39]
Summary
Allergies are a worldwide issue, with approximately 20% of the global population suffering from allergy-caused symptoms including rashes (atopic dermatitis), runny nose (allergic rhinitis), and life-threatening breathing problems (allergy-induced asthma) [1]. Treatments for asthma have been heavily focused on the relief of symptoms on a day-to-day schedule, rather than addressing the underlying causes These treatments are typically inhaled corticosteroids for short-term relief, or longer-lasting therapeutics such as long-acting β2–adrenergic receptors, leukotriene receptor antagonists, long-acting muscarinic antagonists, and for the most severe of symptoms, IgE-specific monoclonal antibody immunotherapy, called omalizumab [10]. These treatments are all directed towards the relief of symptoms, rather than addressing the underlying pathways dysregulated in asthma. Due to the integral role that the IL-4 pathway plays in allergen-induced asthma, it is a prime candidate for inhibitory drugs to treat allergic asthma
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