Abstrakt

The development of targeted therapies for atopic diseases, urticaria and angioedema with biologics is rapid: New ‘targets’ of clinical-therapeutic relevance have been identified, the corresponding targeted antibodies developed, tested in clinical trials and approved for therapy. These include the anti-IgE antibody omalizumab (also effective and approved for the treatment of urticaria), the anti-IL-4/13 receptor-specific antibody dupilumab, the two anti-IL-13 antibodies lebrikizumab and tralokinumab, the anti-TSLP antibody tezepelumab, the two anti-IL-5 antibodies mepolizumab and reslizumab and the anti-IL5 receptor-specific antibody benralizumab for the treatment of atopic diseases. For the treatment of hereditary angioedema, C1 inhibitor and the antibody lanadelumab (directed against kallikrein) have also long been approved as biologics in addition to low-molecular substances. Other therapeutic antibodies are in various stages of development. Furthermore, the range of indications for some very effective biologics has been successfully expanded to include additional diseases. In this context, the first results on biologic therapy of food allergy and eosinophilic oesophagitis are interesting. Increasingly, biologics that address different target structures are also being administered in combination, either simultaneously or sequentially, in order to achieve optimal efficacy. A developing area is the use of biologics in children and the observation of immunological and non-immunological side effects. In some cases, new unexpected side effects and hypersensitivity reactions have emerged, which in turn raise pathomechanistic questions, such as conjunctivitis with dupilumab therapy, which only appears to occur in the treatment of atopic dermatitis, but not in the treatment of other atopic diseases. In dermatology, paradoxical reactions have been described under therapy with some biologics. And immune reactions of type alpha to epsilon to biologics (hypersensitivity reactions) continue to be a problem that is clinically relevant, whereby the selection of an alternative therapeutic agent is a challenge and the diagnostics that support this have not yet been sufficiently incorporated into routine work.

Autoreninformation

Autoren

• U. Jappe^{1, 2}
• K.-C. Bergmann³
• F. Brinkmann⁴
• V. Faihs⁵
• A. Gülsen⁶
• L. Klimek⁷
• H. Renz⁸
• S. Seurig⁹
• C. Taube¹⁰
• S. Traidl¹¹
• R. Treudler¹²
• M. Wagenmann¹³
• T. Werfel¹¹
• M. Worm¹⁴
• T. Zuberbier³

Abteilungen

• ¹ Forschungsgruppe Klinische und Molekulare Allergologie des Forschungszentrums Borstel, Airway Research Center North (ARCN), Mitglied des Deutschen Zentrums für Lungenforschung (DZL),
• ² Interdisziplinäre Allergie-Ambulanz, Medizinische Klinik III, Universität zu Lübeck,
• ³ Institut für Allergieforschung (IFA), Charité Universitätsmedizin Berlin und Fraunhofer Institut für Translationale Medizin und Pharmakologie ITMP, Berlin,
• ⁴ Sektion Kinder- und Jugendmedizin, UKSH, Campus Lübeck, Airway Research Center North (ARCN), Mitglied im Deutschen Zentrum für Lungenforschung (DZL), Lübeck,
• ⁵ Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Klinikum rechts der Isar, Technische Universität München,
• ⁶ Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf,
• ⁷ Zentrum für Rhinologie und Allergologie, Wiesbaden,
• ⁸ Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps Universität Marburg, Member of the German Center for Lung Research (DZL) Marburg,
• ⁹ Nürnberger Interdisziplinäres Zentrum für Allergologie, Klinik für Innere Medizin
• ³ , Schwerpunkt Pneumologie, Klinikum Nürnberg/Campus Nord,
• ¹ 
• ⁰ Ruhrlandklinik – Klinik für Pneumologie, Universitätsmedizin Essen, Essen,
• ¹ 
• ¹ Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover,
• ¹ 
• ² Institute of Allergology IFA, Charité Universitätsmedizin corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin,
• ¹ 
• ³ HNO-Klinik, Universitätsklinikum Düsseldorf,
• ¹ 
• ⁴ Allergologie und Immunologie, Klinik für Dermatologie, Venerologie und Allergologie, Charité Campus Mitte, Universitätsmedizin Berlin

Adresse

Prof. Dr. med. Uta Jappe
Klinische und Molekulare Allergologie
Forschungszentrum Borstel
Leibniz-Lungenzentrum
Parkallee 35
23845 Borstel
Email: [email protected]

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