According to more recent insights, bronchial epithelium plays a key role in the immunopathogenesis of severe asthma. Within the affected airways, epithelial cells can be triggered by e.g. viruses, allergens, or other irritants, causing a subsequent release of pro-inflammatory cytokines, called alarmins, which subsequently induce innate and adaptive immune responses.
Prof. Lena Uller (Lund University, Sweden) explained that novel biologicals targeting the epithelium cell-derived alarmins, i.e. TSLP, IL-33, and IL-25, can inhibit multiple downstream inflammatory pathways, thus offering a broad anti-inflammatory potential for patients with severe uncontrolled asthma. “In the recently published phase 3 study of tezepelumab, targeting TSLP, clinical effectiveness has been shown across both the type2 as well as the non-type2 asthma endotypes .” Although the most pronounced clinical improvements occurred in the type2-subpopulation, further research into anti-TSLP effects also includes patients with type2 low (or non-type) asthma [2,3]. Prof. Uller also pointed out that tezepelumab is the first available anti-alarmin biological (in the USA) and that the currently available biologicals in the Nordic countries (and other Western countries) only target more downstream mechanisms of type2-asthma .
- Menzies-Gow A, et al. N Engl J Med. 2021;384:1800-1809.
- Wechsler ME, et al. Lancet. 2022;10(7):650-660.
- Menzies-Gow A, et al. Respir Res. 2020 Oct 21;21(1):279.
- Uller L. Asthma immunopathology as the determinant of biologic target therapy in severe asthma. Nordic Lung Congress 2022, 01–03 June, Copenhagen, Denmark.
Copyright ©2022 Medicom Medical Publishers
« Common comorbidities in severe asthma Next Article
Advance care planning »
Table of Contents: NLC 2022
NLC 2022 Highlights Podcast
Respiratory Disease and Physical Activity
Physical activity improves asthma control
Tailored exercise needed for COPD patients
Exercise training for IPF patients is feasible but access needs to be improved
Respiratory Disease and Reproduction
Asthma increases risks around delivery
PRO-ART study: unravelling the link between asthma and subfertility
Early-onset and uncontrolled asthma: strong association with recurrent pregnancy loss
Palliative Care in Respiratory Diseases
Advance care planning
Biologics in Asthma
Severe asthma in the spotlights
Common comorbidities in severe asthma
Treatable Traits in Obstructive Airway Diseases
Targeting treatable traits allows a personalised approach to management of (severe) asthma
Challenges in Upper Airway Diseases
Exercise-induced laryngeal obstruction (EILO) is often misdiagnosed
The role of biologics in CRSwNP
The ULANC Group: working together in CRSwNP/asthma
Interstitial Lung Diseases (ILD)
Rheumatoid arthritis-associated ILD
Thoracic ultrasound: a new diagnostic imaging tool in RA-ILD?
Update on treatment of fibrotic ILD
Lung Cancer Screening in the Nordics
Lung cancer screening in Denmark
Points of interest for radiologists screening for lung cancer
E-cigarettes impose detrimental effects on health
Effects of passive vaping in COPD patients
Vaping amongst adolescents: an alarming trend
Tuberculosis and Sarcoidosis
New antigens in sarcoidosis
Detection of latent TB infection key to preventing the spread of the disease
Sarcoidosis guidelines update
New antigens in sarcoidosis