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Rationale and Clinical Results of Inhibiting Interleukin-5 for the Treatment of Severe Asthma

  • ASTHMA (WJ CALHOUN AND SP PETERS, SECTION EDITORS)
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Abstract

Severe asthma is responsible for considerable morbidity and a high proportion of the healthcare costs attributable to asthma. Management is not straightforward as the clinical, pathological and physiological features are heterogeneous and the relationships between these features are poorly understood. In recent years significant progress has been made in understanding this heterogeneity and eosinophilic asthma has emerged as a potentially clinically important phenotype because treatment with monoclonal antibodies against IL-5 is effective. This has required a change in our understanding of the role of eosinophilic airway inflammation in airways disease and the developments of reliable biomarkers of eosinophilic airway inflammation. We will review these developments and describe the clinical experience so far with treatment with monoclonal antibiotics against IL-5.

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Abbreviations

AHR:

Airway hyperresponsiveness

BAL:

Bronchoalveolar lavage

ECP:

Eosinophil cationic protein

EDN:

Eosinophil-derived neurotoxin

EPO:

Eosinophil peroxidise

FeNO:

Exhaled nitric oxide concentration

GM-CSF:

Granulocyte-macrophage colony-stimulating factor

IgE:

Immunoglobulin E

IL-5:

Interleukin-5

MBP:

Major basic protein

RCT:

Randomised controlled trial

RNA:

Ribonucleic acid

ROS:

Reactive oxygen species

Th2:

Type 2 T helper

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Acknowledgments

The authors acknowledge support from the National Institute for Health Research Leicester Respiratory Biomedical Research Unit. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

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Conflict of Interest

Ian D. Pavord has received speaker honoraria for speaking at sponsored meetings from AstraZeneca, Boehringer Ingelheim and GlaxoSmithKline; has served as a consultant for GlaxoSmithKline, AstraZeneca, Novartis, Merck, Boehringer Ingelheim and Aerocrine; has received honoraria for attending advisory panels with Almirall, Aerocrine, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Merck, Sharp & Dohme, Schering-Plough, Novartis, Dey and Napp; has received sponsorship to attend international scientific meetings from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca and Napp. He is also chief medical advisor to Asthma UK, a member of the UK Department of Health Asthma Strategy Group, a member of the BTS SIGN Asthma guideline group and joint editor-in-chief of Thorax.

Rachid Berair declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the author’s research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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  1. Department of Respiratory Medicine, Thoracic Surgery, and Allergy, Institute for Lung and Health, Glenfield Hospital, Leicester, LE3 9QP, UK

    Rachid Berair & Ian D. Pavord

  2. Department of Infection, Immunity and Inflammation, University of Leicester Medical School, Leicester, UK

    Rachid Berair

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Correspondence to Ian D. Pavord.

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Berair, R., Pavord, I.D. Rationale and Clinical Results of Inhibiting Interleukin-5 for the Treatment of Severe Asthma. Curr Allergy Asthma Rep 13, 469–476 (2013). https://doi.org/10.1007/s11882-013-0379-3

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