Current guidelines for patients with severe asthma recommend the addition of oral corticosteroids, which are associated with substantial morbidity, and, for those with allergic asthma, anti-IgE (omalizumab, Xolair).
In a subgroup of patients, the severe asthma is mediated by T-helper 2 (Th2)–type CD4+ T cells which produce a characteristic repertoire of interleukins (ILs), including IL-4, IL-5, and IL-13.
Biological modifiers of Th2-type ILs, such as monoclonal antibodies, soluble receptors, and receptor antagonists may be a rational strategy in this subgroup.
Role of Th2 Immune Pathway Modulation in the Treatment of Severe Asthma and Its Phenotypes.
Image source: Crystal structure of human IL-4. Wikipedia, public domain.