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Anti-IgE and Biologic Approaches for the Treatment of Asthma

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Pharmacology and Therapeutics of Asthma and COPD

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 237))

Abstract

Current asthma treatments are effective for the majority of patients with mild-to-moderate disease. However, in those with more severe refractory asthma, agents other than inhaled corticosteroids and beta-agonists are needed both to better manage this group of patients and to avoid the side effects of high-dose corticosteroids and the social and personal hardship endured. Several biological pathways have been targeted over the last 20 years, and this research has resulted in pharmacological approaches to attempt to better treat patients with severe refractory asthma. The flagship of the biologics, the anti-IgE monoclonal antibody, omalizumab, has proven efficacious in selected subgroups of asthma patients. Tailoring asthma treatments to suit specific subtypes of asthma patients is in keeping with ideals of personalized medicine. Research in the complex interplay of allergens, epithelial host defenses, cytokines, and innate and adaptive immunity interactions has allowed better understanding of the mechanics of allergy and inflammation in asthma. As a result, new biologic treatments have been developed that target several different phenotypes and endotypes in asthma. As knowledge of the efficacy of these biological agents in asthma emerges, as well as the type of patients in whom they are most beneficial, the movement toward personalized asthma treatment will follow.

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Authors and Affiliations

  1. Firestone Institute for Respiratory Health and the Department of Medicine, McMaster University, Hamilton, ON, Canada

    Patrick D. Mitchell, Amani I. El-Gammal & Paul M. O’Byrne

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  1. Patrick D. Mitchell
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  2. Amani I. El-Gammal
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  3. Paul M. O’Byrne
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Correspondence to Paul M. O’Byrne .

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Editors and Affiliations

  1. Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom

    Clive P. Page

  2. Airway Disease Section, Imperial College, National Heart and Lung Institute, London, United Kingdom

    Peter J. Barnes

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Mitchell, P.D., El-Gammal, A.I., O’Byrne, P.M. (2016). Anti-IgE and Biologic Approaches for the Treatment of Asthma. In: Page, C., Barnes, P. (eds) Pharmacology and Therapeutics of Asthma and COPD. Handbook of Experimental Pharmacology, vol 237. Springer, Cham. https://doi.org/10.1007/164_2016_65

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