Treatment targets include several interleukins, immunoglobulin E, and alarmins, pointed out Nicola Hanania, MD, MS, pulmonary critical care physician and director, Airway Clinical Research Center, Baylor College of Medicine, Houston.
Treatment targets for this type of asthma include interleukins 4, 5, and 13, as well as immunoglobulin E and alarmins, but unmet needs remain, pointed out Nicola Hanania, MD, MS, pulmonary critical care physician and director, Airway Clinical Research Center, Baylor College of Medicine, Houston, Texas.
What recent advancements in therapy for T2-high asthma look most promising?
Well, the nice thing about T2-high asthma is that we have identified several targets. We know at least the cytokines, chemokines, and receptors that drive this type of asthma. Of course, it's an evolving field, so we can't claim we know everything.
I talked about the anti-IL-5s [interleukin-5]. IL-5 is an important cytokine. IL-4 and IL-13 are very important cytokines; these are effector cytokines. And then IgE [immunoglobulin E]. These are the ones that now we are targeting. However, there are others.
We have a set of cytokines called alarmins. The alarmins are important cytokines because they drive the inflammatory cascade from right below the epithelium. So one of the promising drugs being developed nowadays is an anti-T SLIT [sublingual immunotherapy]. There are several of them, but one of them is in a phase 3 trial. That may actually be very promising in a way that may work in both T2 and non-T2 asthma.
But there are unmet needs, obviously. We don't have many targets for non-T2 asthma, which maybe constitutes about 40% of all asthmatics out there.