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Anti-interleukin-5 antibody therapy in asthma and allerges

Corren, Jonathan

Current Opinion in Allergy & Clinical Immunology: December 2011 - Volume 11 - Issue 6 - p 565–570
doi: 10.1097/ACI.0b013e32834c3d30
Immunotherapy and new treatments: Edited by Giovanni Passalacqua and Robert Bush

Purpose of review: Interleukin 5 (IL-5) has been shown to play an instrumental role in eosinophilic inflammation in allergic diseases. The purpose of this review is to explore clinical trials of anti-IL-5 antibody therapy that have been conducted in patients with asthma, hypereosinophilic syndromes, eosinophilic esophagitis, atopic dermatitis, Churg-Strauss syndrome, and nasal polyposis.

Recent findings: Recent trials of anti-IL-5 in patients with severe asthma refractory to existing therapies and prominent sputum eosinophilia experienced significant reductions in asthma exacerbations. Studies in patients with hypereosinopihilic syndromes have shown that IL-5 antagonism allows significant reductions in systemic corticosteroid doses while maintaining or improving blood eosinophil counts and symptoms. In children and adults with eosinophilic esophagitis, anti-IL-5 treatment reduced eosinophil numbers in esophageal tissue; it is uncertain whether these findings are predictive of clinical improvement. Clinical studies of individuals with atopic dermatitis do not support efficacy of anti-IL-5 in either reducing allergen patch test intensity or symptoms of chronic dermatitis. In small trials in both Churg Strauss syndrome and nasal polyposis, anti-IL-5 shows promise but larger numbers of patients with these conditions will need to be studied.

Summary: Anti-IL-5 is efficacious in treating patients with severe asthma and sputum eosinophilia and hypereosinophilic syndromes. Larger controlled trials with appropriate endpoints will be necessary to assess the role of anti-IL-5 in other eosinophilic disorders.

Allergy Medical Clinic, Los Angeles, California, USA

Correspondence to Jonathan Corren, MD, Allergy Medical Clinic, 10780 Santa Monica Boulevard, Suite 280, Los Angeles, CA 90025, USA Tel: +1 310 312 5050; e-mail: jcorren@ucla.edu

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