Biologics and airway remodeling in asthma: early, late, and potential preventive effects

G. Varricchi; R. Poto; M. Lommatzsch; G. Brusselle; F. Braido; J. C. Virchow; G. W. Canonica

doi:10.1111/all.16382

journal article Open Access Nov 09, 2024

Biologics and airway remodeling in asthma: early, late, and potential preventive effects

G. Varricchi R. Poto M. Lommatzsch

G. Brusselle F. Braido J. C. Virchow

G. W. Canonica

Allergy Vol. 80 No. 2 pp. 408-422 · Wiley

View at Publisher Save 10.1111/all.16382

Abstract

AbstractAlthough airway remodeling in severe and/or fatal asthma is still considered irreversible, its individual components as a cause of clinical symptoms and/or lung function changes remain largely unknown. While inhaled glucocorticoids have not consistently been shown to affect airway remodeling, biologics targeting specific pathways of airway inflammation have been shown to improve lung function, mucus plugging, and airway structural changes that can exceed those seen with glucocorticoids. This superiority of biologic treatment, which cannot be solely explained by insufficient doses or limited durations of glucocorticoid therapies, needs to be further explored. For this field of research, we propose a novel classification of the potential effects of biologics on airway remodeling into three temporal effects: early effects (days to weeks, primarily modulating inflammatory processes), late effects (months to years, predominantly affecting structural changes), and potential preventive effects (outcomes of early treatment with biologics). For the identification of potential preventive effects of biologics, we call for studies exploring the impact of early biological treatment on airway remodeling in patients with moderate‐to‐severe asthma, which should be accompanied by a long‐term evaluation of clinical parameters, biomarkers, treatment burden, and socioeconomic implications.

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References

Details

Published: Nov 09, 2024
Vol/Issue: 80(2)
Pages: 408-422
License: View

Authors

G

G. Varricchi

Department of Translational Medical Sciences University of Naples Federico II Naples Italy; Center for Basic and Clinical Immunology Research (CISI) University of Naples Federico II Naples Italy; World Allergy Organization (WAO) Center of Excellence Naples Italy; Institute of Experimental Endocrinology and Oncology (IEOS) National Research Council Naples Italy

R

R. Poto

Department of Translational Medical Sciences University of Naples Federico II Naples Italy; Center for Basic and Clinical Immunology Research (CISI) University of Naples Federico II Naples Italy; World Allergy Organization (WAO) Center of Excellence Naples Italy

M

M. Lommatzsch

Department of Pneumology and Critical Care Medicine University of Rostock Rostock Germany

G

G. Brusselle

Department of Respiratory Medicine Ghent University Hospital Ghent Belgium

F

F. Braido

Respiratory Diseases and Allergy Department IRCCS Polyclinic Hospital San Martino Genoa Italy

J

J. C. Virchow

Department of Pneumology and Critical Care Medicine University of Rostock Rostock Germany

G

G. W. Canonica

Respiratory Diseases and Allergy Department IRCCS Polyclinic Hospital San Martino Genoa Italy; Department of Biomedical Sciences Humanitas University Milan Italy; Asthma & Allergy Unit‐IRCCS Humanitas Research Hospital Milan Italy

Cite This Article

G. Varricchi, R. Poto, M. Lommatzsch, et al. (2024). Biologics and airway remodeling in asthma: early, late, and potential preventive effects. Allergy, 80(2), 408-422. https://doi.org/10.1111/all.16382

Biologics and airway remodeling in asthma: early, late, and potential preventive effects

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