This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Google Scholar Articles by Hanania, N. A. PubMed PubMed Citation Articles by Hanania, N. A. Related Content Special Features

Targeting Airway Inflammation in Asthma^*

Current and Future Therapies

^* From the Division of Pulmonary and Critical Care Medicine, Asthma Clinical Research Center, Baylor College of Medicine, Houston, TX.

Correspondence to: Nicola A. Hanania, MD, MS, FCCP, Pulmonary and Critical Care Medicine, Asthma Clinical Research Center, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030; e-mail: Hanania{at}bcm.tmc.edu

Abstract

Asthma is a chronic inflammatory disease of the airway that requires long-term antiinflammatory therapy. Inhaled corticosteroids (ICSs) are recommended for first-line treatment of persistent disease, but not all patients achieve asthma control even when these agents are used in high doses and in combination with other medications, including a long-acting β₂-agonist or a leukotriene modifier. Such patients may require additional therapy. As information about asthma pathophysiology and inflammatory phenotypes continues to increase, and additional antiinflammatory options become available, it may be possible to target antiinflammatory therapy to various aspects of the disease and consequently to improve the treatment of patients with inadequate responses to standard ICS-based therapy. Several novel antiinflammatory therapies are in different stages of clinical development. The most clinically advanced of these is omalizumab, a recombinant humanized monoclonal antibody that specifically targets IgE and is indicated for patients with moderate-to-severe asthma caused by allergies. Omalizumab has demonstrated efficacy in patients with moderate-to-severe asthma and documented evidence of allergen sensitivity. Other key therapy options in clinical development either target proinflammatory cytokines (eg, interleukin-4 and tumor necrosis factor-) or inflammatory cells (eg, T-helper type 2 cells and eosinophils). This review provides an overview of the current and future approaches targeting airway inflammation in patients with asthma.

Key Words: airway inflammation • antiinflammatory therapy • asthma • IgE • inhaled corticosteroids • omalizumab • steroid-resistant asthma