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(Chest. 2006;130:244-250.)
© 2006 American College of Chest Physicians

Cytokines or Their Antagonists for the Treatment of Asthma*

Paul M. O’Byrne, MB, FCCP

* From McMaster University, Hamilton, ON, Canada.

Correspondence to: Paul M. O’Byrne, MB, FCCP, Department of Medicine, McMaster University Medical Center, 1200 Main St West, Hamilton, ON, L8N 3Z5 Canada; e-mail: obyrnep{at}mcmaster.ca

Abstract

T helper (Th) type 2 cytokines, particularly interleukin (IL)-4, IL-5, and IL-13, may be important in the development of allergic asthma. Humanized monoclonal antibodies (MoAbs) against IL-5 and a recombinant human soluble IL-4 receptor (sIL-4R) have been developed as possible treatments. These approaches have not yet proven to be successful in patients with persistent asthma. This may suggest that neither IL-4 nor IL-5 is important in asthma pathogenesis. There is, however, insufficient information about the efficacy of sIL-4R and the anti-IL-5 MoAbs in asthma to draw any firm conclusions about the importance of these Th2 cytokines. Also, the administration of the potentially antiinflammatory cytokines IL-12 and interferon-{gamma} has not shown benefit in asthmatic patients. By contrast, the treatment of severe oral steroid-dependent asthma with soluble tumor necrosis factor-{alpha} receptor has demonstrated very promising results, suggesting that this cytokine plays an important role in the persistence of severe asthma.

Key Words: airway hyperresponsiveness • asthma • interferon-{gamma} • interleukin-4 • interleukin-5 • interleukin-13 • tumor necrosis factor-{alpha}




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