Evaluating the glucagon-like peptide-1 receptor in managing asthma

Abstract

Purpose of reviewThe aim of this study was to discuss the role of glucagon-like peptide-1 (GLP-1) receptor signalling in reducing lung inflammation and potential use for GLP-1 receptor agonists (GLP-1RAs) in management of asthma. Recent findingsAlthough GLP-1RA are currently used for the treatment of type 2 diabetes (T2D) and weight loss in obesity, there is much interest in expanding the indications for use in other diseases, including inflammatory pulmonary disease. In animal models of both acute and chronic pulmonary disease, use of GLP-1RA reduces airway inflammation, obstruction and fibrosis. In particular, GLP-1 receptor (GLP-1R) signalling seems to inhibit allergen-induced type 2 inflammation, making it an attractive agent for asthma. Results are especially promising in disease processes with disturbed metabolic regulation, such as T2D or metabolic syndrome. Retrospective clinical studies demonstrate promising evidence for the use of GLP-1RAs in comorbid diabetes and asthma, although prospective human studies are limited. SummaryHere, we discuss the biology of GLP-1 and GLP-1R signalling, review the preclinical and mechanistic evidence for how GLP-1R signalling may reduce pulmonary inflammation, and summarize recent and upcoming clinical studies. Ultimately, targeting GLP-1R signalling may represent a novel approach for asthma therapy that is glucocorticoid sparing and possibly disease modifying.

Glucagon‐like peptide‐1 receptor agonist use is associated with lower serum periostin

“…Murine asthma models determined that GLP-1RAs decrease production of IL-13, which drives airway mucus metaplasia and airway responsiveness in asthma. 1 In a small sample of non-diabetic patients, GLP-1R activation decreased IL-4 and IL-13 production by lipopolysaccharide-stimulated eosinophils further supporting investigation of the IL-13 pathway and periostin as a biomarker. 8 To advance these findings to the clinical context within the boundaries of current FDA indications, we identified lower serum periostin levels in patients with asthma and obesity treated with GLP-1RAs in the "real world" T2DM care setting.…”

Diabetic endothelial microangiopathy and pulmonary dysfunction

“…GLP-1RAs prevent adult asthmatics' symptoms from deteriorating much. GLP-1RAs could provide a fresh method for treating asthma brought by metabolic malfunction (144)(145)(146)(147)(148)(149). As a result of increased expression of DPP-4, which is induced by the type 2 cytokines interleukin (IL)-4 and IL-13, in diseases of asthma and type 2 inflammation, such as atopic dermatitis and chronic rhinitis, DPP-4i may help with the management of asthma (103,(150)(151)(152)(153)(154).…”

Beneficial Effects of Glucagon-Like Peptide-1 Receptor Agonists in Patients With Asthma: A Literature Review

“…Overall, GLP-1 RAs have been shown to be anti-inflammatory and potentially disease-modifying for asthmatics with diabetes in animal models (Tables 1 , 2 ) [ 7 ]. GLP-1 agonists were also found to decrease eosinophilic-mediated secretion of IL4, IL8, and IL13 in mice with asthma [ 19 ].…”

“…Inflammation in obesity and asthma is a common pathway that could be targeted to reduce symptoms of both diseases. GLP-1 RAs are a nonsteroid alternative that could be used to treat diabetes and asthma [ 7 ]. Some of the common inflammatory mediators are the NLRP3 pathway and IL-6-mediated inflammation that affect both diseases [ 8 ].…”