The efficacy of anti–TNF-? agents in the treatment of juvenile idiopathic arthritis-associated uveitis in a pediatric cohort

Purpose: Biologic therapy has shown promising control in children with often intractable juvenile idiopathic arthritis (JIA)?associated uveitis (JIA?U). Methods: This is a retrospective cohort study of 35 eyes of 35 children who received biologics for JIA?U. Pretreatment and posttreatment data (at 3, 6, 9, 12, 18, 24, and >24 months) were analyzed to determine functional success (stable/improved visual acuity), quiescence success (?0.5 cells in the anterior chamber), complete steroid success (termination of systemic, periocular therapy and decreased topical drops to ?2/day) or systemic steroid success (termination of systemic steroids only), and complete success (all of the above). Results: This study included 35 eyes up to 12 months and 21 eyes beyond 24 months. Steroid?sparing, functional, and quiescence success showed a rate of success of 52.43%, 77%, and 91%, respectively, at 12 months and 66.67%, 85.7%, and 76.2%, respectively, beyond 24 months. Complete success was 34.29% at 12 months, peaking at 18 months (65.62%) and reached 57.14% beyond 24 months. In their final follow?up, the best corrected visual acuity (BCVA) remained the same in 45.71%, improved in 37.14%, and worsened in 17.14% children. Conclusion: Biologic therapy is effective in JIA?U, especially in termination of systemic steroids, stabilization of vision, and maintaining quiescence

Clinical profile and management with immunosuppressants and biologics in Behcet’s uveitis: A cohort of 25 patients from a tertiary eye care center in South India

Purpose: To report the clinical profile of Behcet’s disease and its management with immunosuppressants and biologics in a cohort of 25 patients from a tertiary eye care center in South India. Methods: This was a retrospective, observational study. Records of 45 eyes of 25 patients between January 2016 and December 2021 were retrieved from the hospital database. Complete ophthalmic evaluation and systemic examination by the rheumatologist with appropriate investigations had been done. Results were analyzed using Statistical Package for the Social Sciences (SPSS) software. Results: Males (19, 76%) were found to be more affected than females (6, 24%). Mean age of presentation was 27.68 ± 11.08 years. Twenty patients had bilateral involvement (80%), and unilateral involvement was seen in five patients (20%). Seven eyes of four patients (16%) had isolated anterior uveitis, out of which one patient had unilateral and three patients had bilateral involvement. Twenty?six eyes of 16 patients (64%) had posterior uveitis, out of which six patients had unilateral and 10 had bilateral involvement. Twelve eyes of seven patients (28%) had panuveitis, out of which two patients had unilateral and five had bilateral involvement. Hypopyon was seen in five eyes (11.1%) and posterior synechiae in seven eyes (15.55%). Posterior segment findings included vitritis (24.44%), vasculitis (17.78%), retinitis (17.78%), disc hyperemia (11.11%), and disc pallor (8.89%). Steroids alone were given in five patients (20%) and intravenous methylprednisolone (IVMP) was given in four patients (16%). Immunosuppressive agents along with steroids were given in 20 patients (80%), of which azathioprine alone was given in seven patients (28%), cyclosporin alone was given in two patients (8%), mycophenolate mofetil alone was given in three patients (12%), combination of azathioprine and cyclosporin was given in six patients (24%), and combination of methotrexate and mycophenolate mofetil was given in one patient (4%). Biologics were given in 10 patients (40%) – adalimumab in seven patients (28%) and infliximab in three patients (12%). Conclusion: Behcet’s disease is an uncommon uveitis in India. Addition of immunosuppressants and biologics to conventional steroid therapy gives better visual outcomes.

Advances in systemic juvenile idiopathic arthritis associated-lung disease / 中华实用儿科临床杂志

Systemic juvenile idiopathic arthritis(sJIA) is one of the most serious critical illnesses in childhood, characterized by high fever, recurrent rash, and arthritis, etc.Children with sJIA associated-lung disease(sJIA-LD) are more severely ill and have a worse prognosis, the correlation between the mechanism and age, disease activity, anti-rheumatic drug therapy, applications of biologics, infection and other factors is worth exploring.This article reviews the research progress on the mechanism, risk factors, treatment methods and prognosis of sJIA-LD, so as to provide a theoretical basis for improving the diagnosis and treatment of sJIA and improving the prognosis.

Tuberculose latente em pacientes psoriásicos tratados com imunobiológicos do estado da Paraíba / Latent tuberculosis in psoriatic patients treated with immunobiologics from the state of Paraíba / Tuberculosis latente en pacientes psoriásicos tratados con inmunobiológicos del estado de Paraíba

Objetivo: Investigar a prevalência e os riscos para tuberculose (TB) em pacientes com psoríase em uso de imunobiológicos tratados em centro de referência na Paraíba. Métodos: Trata-se de um estudo transversal, com psoriásicos registrados no Centro de Referência de Psoríase de um Hospital Universitário em parceria com o Centro Especializado de Dispensação de Medicamentos Excepcionais, com idade ≥ 18 anos, tratados com imunobiológicos de setembro/2021 a agosto/2022. Resultados: A amostra de 185 pacientes, foram 94 (50.8%) mulheres, com média de idade de 51,8 ± 16,0 anos,147 (79.4%) eram da capital da Paraíba. A forma de psoríase mais prevalente foi do tipo Vulgar em placas, com 181 (45.9%) pacientes. Todos os pacientes estavam usando imunobiológicos, sendo o inibidor do fator de necrose tumoral o mais utilizado. Observou-se Teste de Mantoux reativo em 12 (6.5%) pacientes e fortemente reativo em 5 (2.7%), e alteração na radiografia de tórax em 6 pacientes. Os 17 pacientes com TB- latente foram tratados com isoniazida por 9 meses, e nenhum desenvolveu a TB-doença. Conclusão: Este estudo foi imperioso para conhecer o perfil epidemiológico dos pacientes com psoríase em uso de imunobiológicos e que estão expostos a um risco maior em desenvolver a TB-doença.

Objective: To investigate the prevalence and risks of tuberculosis (TB) in patients with psoriasis using immunobiologics treated at a referral center in Paraíba. Methods: This is a cross-sectional study with psoriatic individuals registered at the Psoriasis Reference Center at the University Hospita in partnership with the Specialized Center for the Dispensation of Exceptional Medicines, aged ≥ 18 years, treated with immunobiologics from September/2021 to August/2022. Results: The sample of 185 patients who met the criteria were 94 (50.8%) women, with a mean age of 51.8 ± 16.0 years,147 (79.4%) were from the capital of Paraíba. The most prevalent form of psoriasis was the vulgar plaque type, with 181 (45.9%) patients. All patients were using immunobiologicals, and the tumor necrosis factor inhibitor was the most widely used. Reactive Mantoux test was observed in 12 (6.5%) patients and strongly reactive in 5 (2.7%), and chest X-ray changes were observed in 6 patients. The 17 patients with latent TB were treated with isoniazid for 9 months, and none developed TB-disease. Conclusion: This study was imperative to know the epidemiological profile of patients with psoriasis using immunobiologics and who are exposed to a higher risk of developing TB-disease.

Objetivo: Investigar la prevalencia y los riesgos de tuberculosis (TB) en pacientes con psoriasis utilizando inmunobiológicos tratados en un centro de referencia en Paraíba. Métodos: Estudio transversal con individuos psoriásicos registrados en el Centro de Referencia de Psoriasis del Hospital en asociación con el Centro Especializado para la Dispensación de Medicamentos Excepcionales, con edad ≥ 18 años, tratados con productos inmunobiológicos desde septiembre/2021 hasta agosto/2022. Resultados: La muestra de 185 pacientes que cumplieron con los criterios fueron 94 (50,8%) mujeres, con edad promedio de 51,8 ± 16,0 años, 147 (79,4%) eran de la capital de Paraíba. La forma más prevalente de psoriasis fue el tipo de placa vulgar, con 181 (45,9%) pacientes. Todos los pacientes usaban productos inmunobiológicos, y el inhibidor del factor de necrosis tumoral fue el más utilizado. Se observó teste de Mantoux reactiva en 12 (6,5%) pacientes y fuertemente reactiva en 5 (2,7%), y se observaron cambios en la radiografía de tórax en 6 pacientes. Los 17 pacientes con TB latente fueron tratados con isoniazida durante 9 meses, y ninguno desarrolló enfermedad de TB. Conclusión: Este estudio fue imprescindible para conocer el perfil epidemiológico de los pacientes con psoriasis que utilizan productos inmunológicos y que están expuestos a un mayor riesgo de desarrollar la enfermedad de TB.

Recommendations for the Management and Treatment of Asthma in Argentina (RE.M.A) A RAND/UCLA modified Delphi consensus Argentinian Association of allergy and clinical immunology and Argentinian association of respiratory Medicine / Recomendaciones en el manejo y tratamiento del asma en la Argentina (REMA) Consenso Delphi modificado RAND/UCLA de la Asociación Argentina de Alergia e Inmunología Clínica y Asociación Argentina de Medicina Respiratoria

ABSTRACT Asthma is a common chronic airway disease in our country, although with high poor control. Some specialists of the Asociación de Alergia e Inmunología Clínica and Asociación Argentina de Medicina Respiratoria have made recommendations for management and treatment of asthma, using a RAND/UCLA modified Delphi consensus methodology, based on GRADE evidence. This document provides recommendations based on specialist opinions about different strategies to improve adherence. Besides, it provides recommendations about critical issues of mild to severe asthma treatment. It´s recommended to improve adherence, personalized control-based management plan (1 °C), mobile devices (1B) and education (1 °C). Sublingual immunotherapy must be prescribed only in patients with allergic rhinitis, mite associated, and persistent symptoms although appropriate treatment with FEV1> 70 % (1B). Use of fast action bronchodilators associated with inhaled corticosteroids prn in mild asthma (GINA stage 2) has strong recommendation (1A). Use of triple inhaled therapy (long acting anticholinergics, long acting beta 2 agonists and inhaled corticosteroids) is recommended in severe asthma (1B). Biologics has strong recommendations severe asthma: in phenotype T2 with dupilumab (1A), in phenotype allergic T2 with omalizumab (1A) and phenotype eosinophilic T2 with benralizumab or mepolizumab with distinctive characteristic (1A).

RESUMEN El asma es una enfermedad crónica de la vía aérea prevalente en nuestro país, con frecuente mal control. Algunos especialistas de la Asociación de Alergia e Inmunología Clínica y la Asociación Argentina de Medicina Respiratoria han realizado recomendaciones sobre el manejo y tratamiento del asma mediante la metodología de consenso RAND/UCLA Delphi modificada sobre la base de la evidencia científica (GRADE). Este documento provee recomendaciones basadas en la opinión de especialistas y fundamentada en evidencia científica seleccionada en cuanto a la importancia de mejorar la adherencia al tratamiento y seguimiento a través de diferentes estrategias. Así mismo, provee recomendaciones actualizadas en aspectos críticos del tratamiento del asma leve al grave. Se recomienda, para mejorar la adherencia, el uso de planes personalizados de manejo (1 °C), uso de herramientas a través de teléfonos móviles (1B) y educación (1 °C). Con respecto a la inmunoterapia sublingual solo debe ser indicada a pacientes con asociación con rinitis alérgica, asociada a ácaros y síntomas de asma a pesar del tratamiento adecuado con FEV1 > 70 % (1B). Se recomienda fuertemente en el asma leve (escalón 2 GINA) el uso de broncodilatadores de acción rápida asociados a corticoides inhalados a demanda (1A). En asma grave, se recomienda el uso de la triple terapia inhalada con anticolinérgicos de acción prolongada, beta 2 de acción prolongada y corticoides inhaladas (1B). El uso de biológicos en asma grave está fuertemente indicado en fenotipo T2 con dupilumab (1A), T2 alérgico con omalizumab (1A) y en el T2 eosinofílico con benralizumab, o mepolizumab, con sus características distintivas (1A).

New advances in the pathogenesis and drug research of psoriasis / 药学学报

Psoriasis is a chronic, recurrent, and inflammatory skin disease induced by multiple factors. Its typical clinical manifestation is scaly erythema or plaques, which can cause various complications such as metabolic syndrome, cardiovascular disease, and inflammatory arthritis, seriously affecting the quality of life of patients. A deep understanding of the pathogenesis of psoriasis is helpful to discover new therapeutic targets and develop effective new therapeutic drugs, thus having important clinical significance. This manuscript reviews the new advances in the pathogenesis and drug research of psoriasis in recent years.

Estado actual y retos futuros en el tratamiento de las enfermedades reumáticas / Current status and future challenges in the treatment of rheumatic diseases

Las nuevas estrategias, que incluyen el diagnóstico y el tratamiento tempranos, el enfoque de tratamiento dirigido a un objetivo, la remisión como ese objetivo principal del tratamiento, la participación de los pacientes en las decisiones terapéuticas, junto con el desarrollo de nuevos tratamientos efectivos, han cambiado las expectativas de los reumatólogos y de los pacientes con enfermedades reumáticas. Todavía existen, sin embargo, importantes desafíos tales como la seguridad a largo plazo de los tratamientos actuales y poder escoger tratamientos más individualizados y eficaces, de forma tal de elegir el mejor tratamiento para cada paciente. El futuro, como en el resto de la medicina, probablemente sea la prevención del desarrollo de enfermedades reumáticas. Discutiremos estos temas en esta revisión. (AU)

New strategies, including early diagnosis and treatment, targeted therapy, remission as the main objective of treatment, patient involvement in therapeutic decision-making, and the development of new effective therapies, have changed the expectations of rheumatologists and patients with rheumatic diseases.There are still serious challenges, such as the long-term safety of current treatments and the ability to make more individualized and effective treatments to choose the best treatment for each patient. The future, as that of the whole of medical science, will probably lie in preventing the development of rheumatic diseases. We will discuss these issues in this review. (AU)

Pattern of use of biologics in psoriasis among Indian dermatologists – a cross sectional survey

Background and Aims: Biologics are a relatively new class of highly effective drugs in the management of psoriasis. They act on specific immune processes, achieve rapid and sustained clearance and do not cause target organ damage unlike conventional systemic therapy. It appears that their use in our country is not as widespread as in developed nations despite these benefits ; their prohibitive cost may be a major factor for the limited usage. This survey aimed to find out the extent of use and factors hindering usage of biologics for the management of psoriasis by Indian dermatologists. Methods: It was a cross?sectional questionnaire based study. The questionnaire was designed after a focussed group discussion, followed by validation. The survey was sent in the form of a link to Indian dermatologists. The responses were recorded in excel-sheet and the data was analyzed by SPSS ver 25. Results: Of the 310 participants who took part, 287 completed the survey. Two hundred (70%) were users of biologics, while 87 (30%) had never used them. Cost was the major factor which prevented biologic use. Majority of the respondents used biologics in less than 2 cases per month. Secukinumab was the most common biologic used followed by etanercept. The factors which determined choice of biologics were convenience, cost, previous experience, co-morbid conditions and recommendations by an expert. Limitations: A small sample size was the limitation of the study. Dermatologists who do not use biologics may be under?represented in the study. Conclusions: Biologics are not used optimally by Indian dermatologists for management of psoriasis. The cost, fear of adverse effects, lack of awareness and inadequate felt need are major factors which prevent their regular use

Safety and efficacy of ustekinumab in the treatment of Crohn Disease: a systematic review and meta-analysis

ABSTRACT Background and Aims The present systematic review and meta-analysis was designed to estimate the safety and effectiveness of ustekinumab in the treatment of Crohn disease (CD) in clinical trials and observational studies. Methods We retrieved all the related publications from the PubMed, Cochrane, EBSCO, Google Scholar and EMBASE databases using a systematic search strategy. We only included clinical trials and observational studies that were published in English. Results Only 31 studies that met the eligibility criteria out of the 733 identified studies were included. The overall clinical response rate in the cohort studies was of 0.539 (95% confidence interval [95%CI]: 0.419-0.659), and in the clinical trials it was of 0.428 (95%CI: 0.356-0.501). The pooled clinical remission rate was of 0.399 (95%CI: 0.295-0.503) in randomized control trials (RCTs,) and of 0.440 (95%CI: 0.339-0.542) in cohort studies. The rate of adverse effects was of 0.158 (95%CI: 0.109-0.207) in cohort studies and of 0.690 (95%CI: 0.633-0.748) in RCTs. Conclusion Ustekinumab is effective in the treatment of CD. However, more research is required on the safety profiles because there was considerable variation among the included studies. (AU)

Tratamiento exitoso con risankizumab en paciente con psoriasis y HIV / Successful treatment with risankizumab in a patient with psoriasis and HIV

Resumen El tratamiento de la psoriasis en pacientes HIV positivos resulta un desafío, ya que pueden requerir tratamientos sistémicos de carácter inmunosupresor tales como con agentes biológicos, lo que conlleva a un mayor riesgo de infecciones. Se presenta el caso de un paciente HIV positivo con psoriasis grave sin compromiso artropático, refractaria a otros tratamientos. Existen datos limitados sobre el uso de terapias biológicas en pacientes HIV positivos, pero algunos informes de caso sugieren que su uso es eficaz y seguro. Específicamente, la aparición de anticuerpos monoclonales selectivos para la interleucina 23 tales como risankizumab, pueden ofrecer una terapéutica segura y eficaz para pacientes HIV positivos con psoriasis refractaria a otros tratamientos. De todas maneras, se requieren estudios controlados para definir por completo su seguridad y eficacia.

Abstract The treatment of psoriasis in HIV-positive patients is challenging, as they may require systemic immunosuppressive treatment such as biological agents, leading to an increased risk of infections. A case report of an HIV positive patient with severe psoriasis without arthropathic compromise, refractory to other treatments, is presented. There are limited data on the use of biological therapies in HIV-positive patients, but isolated case reports suggest that their use is effective and safe. Specifically, the emergence of monoclonal antibodies selective for interleukin 23 such as risankizumab may offer a safe and effective therapy for HIV-positive patients with psoriasis refractory to other treatments. In any case, controlled studies are required to fully define its safety and efficacy.

Asma grave T2 alto: análisis del diseño de los estudios clínicos de los nuevos biológicos / T2-High Severe Asthma: Analysis of the Design of Clinical Studies of New Biologics

Resumen En los últimos años, la aparición de anticuerpos monoclonales (Biológicos) para el tratamiento del asma grave T 2 alto nos permitió palear las pocas herramientas terapéuticas que teníamos para tratar a este grupo de pacientes, que, aunque pequeño, difiere al manejo del resto de los asmáticos. Al momento, existen diversos trabajos publicados que dieron soporte a las normativas como a las guías de manejo de asma grave en el mundo y fueron tomados por las diferentes sociedades científicas en la elaboración de estas. A pesar de ello, la lectura minuciosa de los mismos deja ver que existen diferencias claras en cuanto a metodología, toma de variables e interpretación de resultados. Con esta premisa, este trabajo permite realizar un análisis crítico de los estudios clínicos de desarrollo Fase III de biológicos en asma grave, tomando en cuenta metodología y diversas variables que conllevan a los resultados publicados.

Abstract In the last years, the appearance of new monoclonal antibodies (biologics) for the treatment of T2-high severe asthma allowed us to use the few therapeutic tools we had to treat this group of patients, which is small but differs from the rest of the asthmatics in its management. So far there are various publications supporting certain rules such as the Guidelines for Severe Asthma Management on a worldwide level, which were used by the different scientific societies for the development of those guidelines. But the thorough reading of cited publications reveals clear differences regarding the methodology, use of variables and interpretation of the results. Based on these premises, this work allows us to conduct a critical analysis of the phase III clinical studies of the development of biologics for severe asthma, taking into account the methodology and different variables that entail the published results.

Application of Belimumab in childhood-onset systemic lupus erythematosus / 中华实用儿科临床杂志

There is no specific medicine for systemic lupus erythematosus (SLE). Compared with adult-onset SLE, childhood-onset SLE is characterized by severe condition, rapid changes, and poor prognosis.Glucocorticoids are the first-line drugs for SLE.However, some are still difficult to be controlled using the conventional drugs like glucocorticoids and immunosuppressive agents.Belimumab is the only biological agent approved for the use in both adults and childhood-onset SLE, although its application in children lacks clinical experiences.This study aims to review the application of Belimumab in childhood-onset SLE.

Recent research on the application of biologics in the treatment of multisystem inflammatory syndrome in children after SARS-CoV-2 infection / 中国当代儿科杂志

Multisystem inflammatory syndrome in children (MIS-C) is a type of hyperinflammatory symptoms similar to Kawasaki disease after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and is commonly observed in children aged 8-10 years. Primary therapeutic medications for MIS-C are intravenous immunoglobulins and glucocorticoids. It has been reported that biologics, such as IL-1 receptor antagonist anakinra, IL-6 receptor antagonist tocilizumab, and TNF-α receptor antagonist infliximab, can be used as an option for critically ill patients. This article elaborates on the mechanism of action of the above biologics and discusses the efficacy and safety biologics in the treatment of MIS-C after SARS-CoV-2 infection, in order to provide methods for the treatment of MIS-C with severe symptoms.

Genetic incorporation of unnatural amino acids into proteins and its translational application in biomedicine / 中国药科大学学报

@#Proteins in the human body are usually made of 20 natural amino acids.Through different amino acid combinations and isomerization, proteins of diverse functions are built.An emerging genetic code expansion technology can introduce unnatural amino acids into specific sites of target protein, endowing the protein with new biological characteristics including covalently binding with proximal proteins, carrying fluorescence, and mimicking specific protein post-translational modifications.In this paper, based on the structure and function of unnatural amino acids, the applications of different types of unnatural amino acids in regulating protein''s stability, studying protein''s conformation, expression level, and localization, and uncovering heretofore unknown protein-protein interactions were reviewed.Besides, genetic code expansion of unnatural amino acids is anticipated to find broad utilities in biomedicine by bringing new ideas and methods to the design and optimization of biologics.

Recent advances in the translation of drug metabolism and pharmacokinetics science for drug discovery and development

Drug metabolism and pharmacokinetics (DMPK) is an important branch of pharmaceutical sciences. The nature of ADME (absorption, distribution, metabolism, excretion) and PK (pharmacokinetics) inquiries during drug discovery and development has evolved in recent years from being largely descriptive to seeking a more quantitative and mechanistic understanding of the fate of drug candidates in biological systems. Tremendous progress has been made in the past decade, not only in the characterization of physiochemical properties of drugs that influence their ADME, target organ exposure, and toxicity, but also in the identification of design principles that can minimize drug-drug interaction (DDI) potentials and reduce the attritions. The importance of membrane transporters in drug disposition, efficacy, and safety, as well as the interplay with metabolic processes, has been increasingly recognized. Dramatic increases in investments on new modalities beyond traditional small and large molecule drugs, such as peptides, oligonucleotides, and antibody-drug conjugates, necessitated further innovations in bioanalytical and experimental tools for the characterization of their ADME properties. In this review, we highlight some of the most notable advances in the last decade, and provide future perspectives on potential major breakthroughs and innovations in the translation of DMPK science in various stages of drug discovery and development.

Treatment of noninfectious uveitis / Tratamento das uveítes não-infecciosas

ABSTRACT Uveitis is a broad term that refers to a large group of eye disorders categorized by intraocular inflammation, a leading cause of visual impairment. Historically, treatment of noninfectious uveitis has depended on corticosteroid drugs. Owing to the myriad of side effects caused by corticosteroids, immunomodulatory therapy has become the preferred treatment for chronic noninfectious intraocular inflammation. Recently, biological response modifiers have established a new era in uveitis therapy, with the range of targets continuing to expand. In this review, we aimed to convey up-to-date information on the treatment of noninfectious uveitis to the general ophthalmologist.

RESUMO Uveíte é um termo amplo utilizado para denominar várias desordens categorizadas como inflamação intraocular, uma causa importante de deficiência visual. Historicamente, o tratamento das uveítes não infecciosas baseou-se no uso de corticosteróides. Devido aos diversos efeitos colaterais do uso de corticosteróides a longo prazo, a terapia imunomoduladora é indicada no tratamento das uveítes não infecciosas crônicas. A introdução dos medicamentos biológicos estabeleceu uma nova era no tratamento das uveítes, com constante desenvolvimento de novas drogas. O objetivo desta revisão é trazer informações atuais sobre tratamento das uveítes não infecciosas para a prática clínica do oftalmologista geral.

Biotherapy trends in asthma: from the discovery of IgE to anti-IgE antibody production / 中华实用儿科临床杂志

Asthma is the most common chronic respiratory disease in children.Currently, asthma symptoms can be well controlled under initial treatment.For moderate and severe asthma that cannot be controlled by initial treatment, biological therapy is a new option.Among them, the anti-IgE antibody (Omalizumab) is the earliest biological agent to be marketed for the treatment of asthma, followed by a large number of novel monoclonal antibodies targeting different sites.In this paper, the immune mechanism, classification and the development history of biological therapy of asthma were summarized, and the trends of biological therapy of asthma were prospected.

Guia prático de abordagem da criança e do adolescente com asma grave: Documento conjunto da Associação Brasileira de Alergia e Imunologia e Sociedade Brasileira de Pediatria / Practical guide to approaching children and adolescents with severe asthma: a joint document of the Brazilian Association of Allergy and Immunology and the Brazilian Society of Pediatrics

Asma grave é a asma que requer tratamento com altas doses de corticosteroide inalado associado a um segundo medicamento de controle (e/ou corticosteroide sistêmico) para impedir que se torne "descontrolada" ou permaneça "descontrolada" apesar do tratamento. Asma grave é considerada um subtipo de asma de difícil tratamento. A prevalência em crianças evidenciada pelo International Study of Asthma and Allergies in Childhood variou entre 3,8% e 6,9%. Existem diversos instrumentos para avaliação subjetiva, como diários de sintomas e questionários, bem como para avaliação objetiva com função pulmonar e avaliação da inflamação por escarro induzido, ou óxido nítrico exalado. A abordagem terapêutica varia desde doses altas de corticosteroide inalado e/ou oral, broncodilatadores de longa duração, antaganonistas de receptores muscarínicos, até os mais recentes imunobiológicos que bloqueiam a IgE ou IL-5.

Severe asthma is asthma that requires treatment with high doses of inhaled corticosteroids in combination with a second control drug (and/or a systemic corticosteroid) to prevent it from becoming "uncontrolled" or remaining "uncontrolled" despite treatment. Severe asthma is considered a difficult-to-treat asthma subtype. The prevalence in children found by the International Study of Asthma and Allergies in Childhood ranged from 3.8% to 6.9%. There are several instruments for subjective assessment, such as symptom diaries and questionnaires, as well as for objective assessment, including pulmonary function testing and evaluation of inflammation by induced sputum or exhaled nitric oxide. The therapeutic approach includes high doses of inhaled and/or oral corticosteroids, long-acting bronchodilators, muscarinic receptor antagonists, and the latest biologics that block IgE or IL-5.

Development of therapeutic biologics in cancer treatment / 中国临床药理学与治疗学

Cancer treatment is always the focus of pharmaceutical development while therapeutic biologics play an important role alongside. This review is focused on the development of therapeutic biologics in cancer treatment and categorized by targeted therapy and immunotherapy by mechanism. In targeted therapy, monoclonal antibodies, biosimilars and antibody-drug conjugates are discussed in details, while for immunotherapy, checkpoint inhibitors, T-cell transfer therapy and bispecific antibody are introduced, respectively.

Considerations and application status of selection marker for generation of recombinant biologics producing mammalian cell lines / 药学学报

The major challenge in the development of recombinant biologics lies in generating and isolating rare high-producing stable single clone in a short period of time. The selection marker is an essential component of the plasmid vector, it plays an important part in the generation and screening of producing cell lines. Engineering the selection marker to enhance the stringency of selection for high producing cells is one of the most effective approaches to improve the cell line development process. Here, using Chinese hamaster overy (CHO) cells as an example, we introduce the application of selection marker for generation of recombinant biologics producing mammalian cell lines, methods of engineering the selection markers to enhance the selection stringency, and propose considerations on cell substrate stability and selection marker safety, in order to provide references for high-efficiency development of recombinant biologics.