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Specific Therapies for Asthma Endotypes: A New Twist in Drug Development

  • Ulrich M. ZisslerEmail author
Chapter
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Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)

Abstract

Asthma is a heterogeneous disease mainly affecting the lower airways and hallmarked by a chronic lung tissue inflammation that is strongly influenced by environmental and immunological factors. In a subgroup of asthmatics, respiratory infections are associated with the development of chronic disease and more frequent inflammatory exacerbations. Nevertheless, patients suffering from different asthma subgroups are treated with mainly non-specific and symptom-related using anti-inflammatory drugs and bronchodilators. Therefore, it is of great importance to define molecular patterns of asthma and allergy as basis for endotype definitions, rather than using clinical disease phenotypes. In addition, a number of factors can contribute to poor responses, while underlying patho-biological differences are increasingly recognized to play a role. These factors include novel biomarkers as well as well-known pathways but also consideration of the influence of the airway microbiome. With respect to this, specific drugs are developed targeting cellular components (e.g. eosinophils, neutrophils, Th9 cells) or specific mediators (e.g. IgE, FceR, IL5, TSLP) but also key regulators such as GATA3. In addition, also viral-induced asthma is attracting notice and development of anti-viral therapy strategies are promoted.

Keywords

Asthma Endotypes Lung inflammation Biomarkers 

Abbreviations

ACQ

Asthma control questionnaire

BHR

Bronchial hyperresponsiveness

CCL

CC-chemokine ligand

CD

Cluster of differentiation

CLCA1

Calcium-activated chloride channel protein 1

FcεRI

High-affinity IgE receptor I

FDA

US Food and Drug Administration

FeNO

Fraction of exhaled nitric oxide

FEV1

Volume of air expelled in the first second of a forced expiration

huMAb

Humanized monoclonal antibody

ICS

Inhaled corticosteroids

Ig

Immunoglobulin

IL

Interleukin

iNOS

Inducible nitric oxide synthase

LABA

Long acting beta2 agonist

LPS

Lipopolysaccharide

mAb

Monoclonal antibody

OCS

Oral corticosteroid

POSTN

Periostin

RSV

Respiratory syncytial virus

Th

T helper

TSLP

Thymic stromal lymphopoietin

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Center of Allergy & Environment (ZAUM)Technical University of MunichMunichGermany
  2. 2.Helmholtz Center MunichGerman Research Center for Environmental HealthMunichGermany
  3. 3.German Center for Lung Research (DZL), CPC-MMunichGermany

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