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The potential use of tyrosine kinase inhibitors in severe asthma

Guntur, Vamsi P.; Reinero, Carol R.

Current Opinion in Allergy and Clinical Immunology: February 2012 - Volume 12 - Issue 1 - p 68–75
doi: 10.1097/ACI.0b013e32834ecb4f
MECHANISMS OF ALLERGY AND ADULT ASTHMA: Edited by Stephen T. Holgate and J. Andrew Grant

Purpose of review Severe asthma comprises heterogeneous phenotypes that share in common a poor response to traditional therapies. Recent and ongoing work with tyrosine kinase inhibitors suggests a potential beneficial role in treatment of severe asthma.

Recent findings Various receptor and nonreceptor tyrosine kinase pathways contribute to aspects of airway inflammation, airway hyperresponsiveness, and remodeling of asthma. Selective and nonselective tyrosine kinase inhibitors may be useful to block pathways that are pathologically overactive or overexpressed in severe asthma. Recent in-vivo studies have demonstrated the utility of inhibitors against specific tyrosine kinases (epidermal growth factor receptor, c-kit/platelet derived growth factor receptor, vascular endothelial growth factor receptor, spleen tyrosine kinase, and janus kinase) in altering key aspects of severe asthma.

Summary Asthma and even severe asthma does not consist of a single phenotype. Targeting key inflammatory and remodeling pathways engaged across subphenotypes with tyrosine kinase inhibitors appears to hold promise.

aDivision of Pulmonary, Critical Care and Environmental Medicine, School of Medicine

bDepartment of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA

Correspondence to Vamsi P. Guntur, MD, MSc, Division of Pulmonary, Critical Care and Environmental Medicine, University of Missouri, Five Hospital Drive, DCO43.00 Columbia, MO 65212, USA. Tel: +1 573 882 9072; fax: +1 573 884 4892; e-mail:

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