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Treating severe asthma: targeting the IL-5 pathway

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  1. Airway gene expression identifies subtypes of type 2 inflammation in severe asthma

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Increased all-cause mortality in concomitant atopic dermatitis and asthma: A nationwide registry-based study

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  3. Clinical manifestations and impact on daily life of allergy to polyethylene glycol (PEG) in ten patients

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Airway gene expression identifies subtypes of type 2 inflammation in severe asthma

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. The effect of tezepelumab on airway hyperresponsiveness to mannitol in asthma (UPSTREAM)

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Real-world evidence: Methods for assessing long-term health and effectiveness of allergy immunotherapy

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  4. Phenotype and severity of asthma determines bronchial epithelial immune responses to a viral mimic

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  • Stefania Principe
  • Celeste Porsbjerg
  • Sisse Bolm Ditlev
  • Ditte Kjaersgaard Klein
  • Korneliusz Golebski
  • Nanna Dyhre-Petersen
  • Yoni E van Dijk
  • Job J M H van Bragt
  • Lente L H Dankelman
  • Sven-Erik Dahlen
  • Christopher E Brightling
  • Susanne J H Vijverberg
  • Anke H Maitland-van der Zee
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Severe asthma is a heterogeneous disease with different phenotypes based on clinical, functional or inflammatory parameters. In particular, the eosinophilic phenotype is associated with type 2 inflammation and increased levels of interleukin (IL)-4, IL-5 and IL-13). Monoclonal antibodies that target the eosinophilic inflammatory pathways (IL-5R and IL-5), namely mepolizumab, reslizumab, and benralizumab, are effective and safe for severe eosinophilic asthma. Eosinophils threshold represents the most indicative biomarker for response to treatment with all three monoclonal antibodies. Improvement in asthma symptoms scores, lung function, the number of exacerbations, history of late-onset asthma, chronic rhinosinusitis with nasal polyposis, low oral corticosteroids use and low body mass index represent predictive clinical markers of response. Novel Omics studies are emerging with proteomics data and exhaled breath analyses. These may prove useful as biomarkers of response and non-response biologics. Moreover, future biomarker studies need to be undertaken in paediatric patients affected by severe asthma. The choice of appropriate biologic therapy for severe asthma remains challenging. The importance of finding biomarkers that can predict response continuous an open issue that needs to be further explored. This review describes the clinical effects of targeting the IL-5 pathway in severe asthma in adult and paediatric patients, focusing on predictors of response and non-response.

Original languageEnglish
JournalClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
Volume51
Issue number8
Pages (from-to)992-1005
Number of pages14
ISSN0954-7894
DOIs
Publication statusPublished - Aug 2021

ID: 65066147