Abstract

The biologics authorized for the add-on therapy of severe asthma are monoclonal antibodies (mAbs). Before they are considered for therapy intensification, the patient’s asthma endotype is determined on the basis of phenotypic characteristics. So far, 5 biologics are available that target the signaling pathways of the “TH2-high” asthma endotype, in which cytokines of the inflammation cascade mediated by type 2 T-helper cells are upregulated. The corresponding phenotype of this inflammatory endotype is severe eosinophilic asthma, with elevated eosinophils, immunoglobulin E, and fractional exhaled nitric oxide (FeNO). In contrast, the heterogeneous “TH2-low” endotype is not yet sufficiently understood. Frequently described in this variant is an increase of sputum neutrophils and an increased expression of the TH17-mediated interleukin-17 signaling pathway. There are numerous biologics currently in clinical trials, the thymic stromal lymphopoietin (TSLP) mAbs in particular have shown promising results independent of the asthma phenotype.

Author Details

Authors

• Nadja Struß¹
• Jens M. Hohlfeld¹,²,³

Departments

• ¹ Fraunhofer Institute for Toxicology and Experimental Medicine ITEM,
• ² Department of Respiratory Medicine, Hannover Medical School,
• ³ Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research, Hannover, Germany

Address

Prof. Dr. med. Jens M. Hohlfeld, Division Director, Respiratory Research, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Feodor-Lynen-Str. 15, 30625 Hanover
Email: [email protected]

Citation