哮喘联盟

   摘要
   虽然气道炎症是哮喘发病的关键已获得认可，但临床病程的显著异质性和对治疗应答的差异成为新的有效的生物学药物发展的挑战。生物制药已被证明是一种新的治疗方法，它是以关键细胞和介质为目标，促进哮喘患者的肺部炎症应答的一种方法。该方法引导以IL-4， IL-5 和 IL-13为目标的生物制剂的发展。值得注意的是除抗-IgE单克隆抗体奥马珠单抗外，以细胞因子为目标的生物制剂在哮喘患者的早期临床试验中大多令人失望（尽管在哮喘动物模型实验中显示非常有效）。显然以抗细胞因子为基础的治疗更有可能在某些哮喘表型的患者中具有显著的疗效。不同的生物指标和遗传识别的发展可能有助于确认此类哮喘患者。本文回顾性总结了最新疗效证据或其他在哮喘患者中以单克隆抗体为基础的治疗。
 

（苏楠 审校）
Immunotherapy. 2013 Nov;5(11):1255-64. doi: 10.2217/imt.13.118.
 

An update on biologic-based therapy in asthma.
 

Walsh GM.
 

Abstract
Although it is recognized that airway inflammation is key to asthma pathogenesis, the marked heterogeneity in its clinical course and variations in response to treatment make it a challenging condition for the development of novel and effective biologic-based therapies. Biopharmaceutical approaches have identified new therapies that target key cells and mediators that drive inflammatory responses in the asthmatic lung. Such an approach resulted in the development of biologics targeted at inhibiting IL-4, IL-5 and IL-13. With the notable exception of the anti-IgE monoclonal antibody omalizumab, early clinical trials with cytokine-targeted biologics in patients with asthma were, for the most part, disappointing, despite being highly effective in animal models of asthma. It is becoming apparent that significant clinical effects with anticytokine-based therapies are more likely in carefully selected patient populations that take asthma phenotypes into account. The development of discriminatory biomarkers and genetic profiling may aid identification of such patients with asthma. This review summarizes recent evidence demonstrating the effectiveness or otherwise of monoclonal antibody-based therapies in patients with asthma.
 

Immunotherapy. 2013 Nov;5(11):1255-64. doi: 10.2217/imt.13.118.