Anti-interleukin-5 therapy in severe asthma

Abstract

Asthma is a chronic inflammatory disorder of the airways that leads to acute symptoms, exacerbations and sometimes, for a small part of the asthmatic population, fatal or near-fatal exacerbations.This as yet significant minority of individuals present with severe asthma and have persisting daily symptoms, and exacerbations despite compliance with high doses of inhaled steroids and additional treatment. For more than a decade, the pharmacological management of patients with severe asthma has focused on evaluating specific cytokines. The rationale of this approach is based on the distinguished key role played by eosinophils in the asthma inflammatory processes. Eosinophils are recruited from the circulation to airways where they cause airway damage via different mechanisms. Eosinophils are regulated in terms of their recruitment, activation, growth, differentiation and survival by interleukin (IL)-5. Abundant data from in vitro experiments, animal models and clinical trials has confirmed that IL-5 inhibition may be an effective approach for the treatment of asthma, especially severe asthma. Interfering with eosinophil function or reducing their numbers has been one of the most important goals of therapeutic monoclonal antibodies, which target cytokine receptor interactions in asthma, particularly IL-5. This review will consider new treatments options for severe asthma, particularly those targeting IL-5, that have already been evaluated in clinical trials in asthmatic patients. @ERSpublications Rationale, recent advances and future developments of anti-IL-5 therapy in patients with severe asthma http://ow.ly/n3viv

Modulatory effects of levamisole and garlic oil on the immune response of Wistar rats: Biochemical, immunohistochemical, molecular and immunological study

“…Recently, garlic extract has been reported to exert a stimulatory effect on TNF-α gene expression in murine macrophages (27). However, in the combined group in the present study, GO reduced LEVA-induced serum TNF-α elevation, thus implying that GO has a stimulatory effect on basal macrophage activity, which is concordant with the results of a previous study (28).IL-5 has a central role not only in the stimulation of B-cell growth and Ig production, but also in the production, mobilization, activation, recruitment, proliferation and survival of eosinophils at the site of inflammation (29,30). The downregulating effect of GO on LEVA-induced serum IL-5 levels and gene expression in circulating leukocytes and the thymus is concordant with its recently reported anti-allergic effects (31).…”

Asthma: still a promising future?

“…A new series on asthma is, therefore, very welcome in the European Respiratory Review in order to focus on specific areas discussed in recent findings. These series articles, written by expert opinion leaders, can be used to stimulate new ideas as well as provide new forms of management and treatment [6]. The articles deal with hot topics requiring balanced expertise and opinion.…”

Future perspectives on rare pulmonary diseases and rare presentations of common disorders

“…Thus, the article by WENER and BEL [4] informs us how we can learn to distinguish between ''difficult-tocontrol'' and ''severe refractory'' asthma, as well as how to practically manage these difficult situations. The review by GARCIA et al [5] illustrates the possible role of anti-interleukin-5 compounds in the treatment of severe eosinophilic asthmatic patients with a history of frequent exacerbations. MONTANI et al [6] extensively review the issue of drug-induced pulmonary arterial hypertension (PAH); a story which resembles that of the Arab Phoenix rising from its ashes.…”