Use of biologicals as immunotherapy in asthma and related diseases

Abstract

Recent advances in our understanding of the immune-mediated inflammatory pathways in asthma and other allergic diseases have resulted in the development of novel biological compounds for the treatment of these conditions. These compounds offer an advantage over glucocorticosteroid therapy by specifically targeting components of the immunologic cascade, thereby allowing patients to reduce or discontinue their glucocorticosteroid treatment. Another potential advantage of biological compounds is that they may provide additional anti-inflammatory benefits, over and above those provided by glucocorticosteroid therapy, for patients who continue to have evidence of refractory asthma. The anti-IgE monoclonal antibody omalizumab is already being used for the treatment of allergic asthma and a number of other biological therapies are currently in various stages of clinical development. The purpose of this review is to summarize the data from these studies and to provide a rationale for the use of these compounds in asthma and related allergic airway diseases.

Keywords::

• anti-IgE
• anti-IL-2 receptor
• anti-IL-4
• anti-IL-5
• anti-IL-9
• anti-IL-13
• asthma
• biologic therapy
• omalizumab
• TNF-α

Financial & competing interests disclosure

R Leigh is a Canadian Institutes of Health Research Clinician–Scientist (Phase II), an Alberta Heritage Foundation for Medical Research Clinician Investigator and holds the GSK-CIHR Professorship in Inflammatory Lung Disease at the University of Calgary. He has participated as a speaker in scientific meetings or courses organized and financed by various pharmaceutical companies (AstraZeneca Canada Inc., GlaxoSmithKline Canada Inc., Nycomed Canada Inc. and Novartis Pharmaceuticals Canada Inc.) and has consulting arrangements with AstraZeneca Canada Inc. and GlaxoSmithKline Canada Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.