New Therapeutic Modalities for Asthma: Biologicals from a Practical Point of View / 대한내과학회지

ABSTRACT

Asthma is a representative allergic disease of chronic airway inflammation. Dyspnea, wheezing, cough, and chest tightness are typical symptoms. Treatment consists of inhaled corticosteroid, beta2 agonist, leukotriene modifiers, and xanthines such as theophylline. Clinical practice guidelines for asthma have been developed since early 1990s. However, there are still many uncontrolled asthma patients with severe refractory symptoms, frequent exacerbations and even mortality. These patients cause high socioeconomic burden but the management of these patients are not well covered by clinical practice guidelines. High-dose steroid, methotrexate, cyclosporine, gold, IVIG, and macrolides have been suggested as therapeutic modalities for refractory asthma but with limited treatment effect and side effects. It is necessary to develop new therapeutic modalities for asthma. Biologicals, or biologics, are a variety of protein-based therapeutics, e.g. antibodies, soluble receptors, recombinant protein-based receptor antagonists and other related structures. New biologicals for the treatment of asthma are being developed. Here I will focus on three biologicals from a practical point of view a humanized monoclonal anti-IgE antibody (omalizumab), anti-IL5, and TNF-alpha antagonist.