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Anti-interleukin-5 antibody therapy in asthma and allerges

Corren, Jonathan

Current Opinion in Allergy & Clinical Immunology:
doi: 10.1097/ACI.0b013e32834c3d30
Immunotherapy and new treatments: Edited by Giovanni Passalacqua and Robert Bush
Abstract

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.

Author Information

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

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.