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Targeting the interleukin 5 pathway for treatment of severe bronchial asthma

Publication at Faculty of Medicine in Hradec Králové |
2021

Abstract

Biological treatment targets the immune process in the body and changes their course with a reduction in the pathological process. Biological treatment with monoclonal antibodies has been most widely used in the treatment of allergic eosinophilic and non-allergic eosinophilic bronchial asthma (so-called "type-2 high" inflammation).

Three molecules targeting interleukin 5 (mepolizumab, reslizumab, benralizumab) are now approved within the European Union. Interleukin 5 is a key cytokine for the growth, differentiation and escape of eosinophils from the bone marrow, as well as for the recruitment and activation of eosinophils in tissues.

Eosinophils infiltrate lung tissue and participate in its damage both through their cytokines and the production of lipid mediators and cytotoxic proteins. Simultaneously mentioned "antieosinophilic" molecules also solve the comorbidity of "type-2 high" asthma - chronic hyperplastic rhinosinusitis with nasal polyposis and non-clonal hypereosinophilic syndrome.

In severe asthmatics with frequent exacerbations, the use of biologic therapy is often a life-saving treatment in the long term.