Biologic targeted therapy in allergic asthma - 2014 update

With more than 300 million people worldwide affected by asthma and with roughly 5% to 10% of this population living with severe, uncontrolled asthma, the need for new biologic therapies is significant.

The new therapies currently in trials are aimed at the following targets:

- IgE
- interleukin (IL)-4 and IL-4 receptor
- IL-5 and IL-13
- tumor necrosis factor-alpha
- CRTh2
- toll-like receptors (TLR) 7 and 9


The curved leucine-rich repeat region of toll-like receptors, represented here by TLR3. Image source: Wikipedia.



Pathogen Recognition Receptors, TLRs. This video is from: Janeway's Immunobiology, 7th Edition Murphy, Travers, & Walport. Source: Garland Science.

Since the approval of omalizumab in 2003, the development of biologic asthma therapies has grown at a remarkable pace. With approximately 30 drugs currently in clinical trials and dozens more in development, the future of asthma biologic therapies seems as promising as ever. However, the outcome of many trials has led to disappointment. Despite several setbacks, researchers remain focused on elucidating the complex pathophysiology of asthma. Given the lack of overwhelming positive responses, these results have emphasized that asthma is a complex clinical syndrome with multiple underlying genotypes and clinical phenotypes.

The hope is that asthma biologic therapies will eventually be tailored to an individual's asthma phenotype. It is unlikely that there is one “magic bullet” to cure all patients with asthma.

References:

Biologic targeted therapy in allergic asthma.Annals of Allergy, Asthma & Immunology
Volume 112, Issue 2 , Pages 108-115, February 2014 http://buff.ly/N6337Y