Targeting airway remodeling
Experimental and human studies have demonstrated that glucocorticoids
and certain anti-inflammatory drugs can reduce inflammation and
morbidity in mild to moderate asthma. However, evidences of beneficial
effects of glucocorticoids on airway remodeling have not been
demonstrated, with several reports showing contradictory results17,
113,
114. The introduction of several
biological immunotherapies (e.g., anti-IgE, anti-IL-5/IL-5Rα,
anti-IL-4Rα, anti-TSLP)2,
115 has favored the development of a
personalized medicine approach for the treatment of patients with severe
asthma 116-119. There
is some evidence that these biologics can improve not only clinical
symptoms but also certain features of airway remodeling and functional
decline of FEV1. Therefore, it will be important to
evaluate the effects of biological immunotherapies in randomized
clinical trials (RCTs) and real-life settings120,
121.