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Review
. 2021 Jul;59(4):389-396.
doi: 10.1016/j.resinv.2021.03.003. Epub 2021 Apr 20.

Clinical effects and immune modulation of biologics in asthma

Norihiro Harada  1 , Jun Ito  2 , Kazuhisa Takahashi  3
Affiliations
Review

Clinical effects and immune modulation of biologics in asthma

Norihiro Harada et al. Respir Investig. 2021 Jul.

Abstract

Asthma is considered a syndrome composed of heterogeneous disorders involving complex chronic airway inflammation. Patients with severe asthma, prolonged symptoms, and frequent asthma exacerbations, despite high doses of inhaled corticosteroids, may benefit from treatment with biologics. Four types of biologics are available for severe asthma, including an anti-immunoglobulin E (IgE) antibody (omalizumab), anti-interleukin (IL)-5 antibody (mepolizumab and reslizumab), anti-IL-5 receptor α antibody (benralizumab), and anti-IL-4 receptor α antibody (dupilumab). Biologics for patients with severe asthma demonstrate high therapeutic efficacy and provide significant clinical benefits, including the prevention of asthma exacerbations, alleviation of symptoms, improvement in the quality of life and respiratory function, and reduction in frequencies of hospitalization and emergency outpatient visits. This review provides an overview of the modulation of immunological features by each of the four established biologics in patients with severe allergic asthma. Given the extensive immunomodulatory effects of biologics, further analyses of their precise effects on the human immune system are warranted.

Keywords: Asthma; Biologics; Immunomodulator; T2 inflammation.

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Conflict of interest statement

Conflict of Interest Norihiro Harada reports personal fees from AstraZeneca, GSK, Novartis, and Sanofi outside the submitted work and has a pending patent application (Japanese Patent Application 2018-097070). Kazuhisa Takahashi reports grants and personal fees from AstraZeneca, Boehringer Ingelheim, Chugai, Eli Lilly, KYORIN, MSD, Nobelpharma, Novartis, ONO, Pfizer, TEIJIN, grants from Astellas, GSK, Kyowa Hakko Kirin, MiZ, MOCHIDA, NIPRO, NIPPON SHINYAKU, TAIHO, TOYAMA CHEMICAL, TSUMURA, Sanofi, SHIONOGI, TORII, and personal fees from Bristol-Myers, Eisai, Meiji Seika, Mitsubishi Tanabe, Otsuka, PAREXEL, and Sumitomo Dainippon outside the submitted work. The remaining author have no conflicts of interest.