Anti-Tumor Necrosis Factor for Supplementary Management in Severe Asthma: A Systematic Review and Meta-analysis

Ahmad, Suhana; Noor, Norhayati Mohd; Syafirah, E.A.R. Engku Nur; Irekeola, Ahmad Adebayo; Shueb, Rafidah Hanim; Chan, Yean Yean; Barnes, Peter J.; Mohamud, Rohimah

doi:10.1089/jir.2022.0211

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…Several cytokines, including IL-1, IL-8, IL-17, IL-23, IL-33, interferon-γ, and tumor necrosis factor-α (TNF-α), have been proposed as potential biomarkers for severe asthma characterized by T2-low [ 17 , 47 - 50 ]. Antibodies for IL-1 (anakinra), IL-17 (brodalumab), and TNF-α (etanercept and golimumab) have been suggested as potential biological agents for this trait associated with neutrophilic inflammation [ 51 - 53 ]. Additionally, there was an investigation targeting Th 17 cells, which mediate neutrophilic inflammation in asthma [ 54 ].…”

Section: Potential Biomarkers and Biologics For T2-low Asthmamentioning

confidence: 99%

Tailored Biologics Selection in Severe Asthma

Kim,

Kim

2024

Tuberc Respir Dis

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The management of severe asthma presents a significant challenge in asthma treatment. Over the past few decades, remarkable progress has been made in developing new treatments for severe asthma, primarily in the form of biological agents. These advances have been made possible through a deeper understanding of the underlying pathogenesis of asthma. Most biological agents focus on targeting specific inflammatory pathways known as type 2 inflammation. However, recent developments have introduced a new agent targeting upstream alarmin signaling pathways. This opens up new possibilities, and it is anticipated that additional therapeutic agents targeting various pathways will be developed in the future. Despite this recent progress, the mainstay of asthma treatment has long been inhalers. As a result, the guidelines for the appropriate use of biological agents are not yet firmly established. In this review, we aim to emphasize the current state of biological therapy for severe asthma and provide insights into its future prospects.

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Section: Potential Biomarkers and Biologics For T2-low Asthmamentioning

confidence: 99%

Tailored Biologics Selection in Severe Asthma

Kim,

Kim

2024

Tuberc Respir Dis

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“…Another study found that administration of ETN for 12 weeks modestly reduced AHR, improved asthma symptom control, quality of life, and lung function, and reduced the expression levels of membrane-bound TNF on peripheral blood mononuclear cells ( 130 ). Other anti-TNF-α treatments, such as infliximab, adalimumab, and golimumab, have similarly failed to provide promising outcomes ( 131 ). Although anti-TNF-α has been shown to improve asthma control in animal models, patients with severe asthma have not benefited from this therapy because there is limited evidence of improved lung function and reduced asthma exacerbation.…”

Section: Biologicals Targeting “Type-2-low” Asthmamentioning

confidence: 99%

T-helper cells and their cytokines in pathogenesis and treatment of asthma

2023

Front. Immunol.

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Prosperous advances in understanding the cellular and molecular mechanisms of chronic inflammation and airway remodeling in asthma have been made over the past several decades. Asthma is a chronic inflammatory disease of the airways characterized by reversible airway obstruction that is self-resolving or remits with treatment. Around half of asthma patients are “Type-2-high” asthma with overexpression of type 2 inflammatory pathways and elevated type 2 cytokines. When stimulated by allergens, airway epithelial cells secrete IL-25, IL-33, and TSLP to derive a Th2 immune response. First ILC2 followed by Th2 cells produces a series of cytokines such as IL-4, IL-5, and IL-13. TFH cells control IgE synthesis by secreting IL-4 to allergen-specific B cells. IL-5 promotes eosinophil inflammation, while IL-13 and IL-4 are involved in goblet cell metaplasia and bronchial hyperresponsiveness. Currently, “Type-2 low” asthma is defined as asthma with low levels of T2 biomarkers due to the lack of reliable biomarkers, which is associated with other Th cells. Th1 and Th17 are capable of producing cytokines that recruit neutrophils, such as IFN-γ and IL-17, to participate in the development of “Type-2-low” asthma. Precision medicine targeting Th cells and related cytokines is essential in the management of asthma aiming at the more appropriate patient selection and better treatment response. In this review, we sort out the pathogenesis of Th cells in asthma and summarize the therapeutic approaches involved as well as potential research directions.

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