Severe eosinophilic asthma: from the pathogenic role of interleukin-5 to the therapeutic action of mepolizumab

Drug Des Devel Ther. 2017 Oct 30:11:3137-3144. doi: 10.2147/DDDT.S150656. eCollection 2017.

Abstract

Mepolizumab is an anti-interleukin-5 (IL-5) humanized monoclonal antibody that has been recently approved as an add-on biological treatment for severe eosinophilic asthma, by both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Moreover, mepolizumab is also currently included within the step 5 of the Global Initiative for Asthma guidelines, as an add-on therapy for severe uncontrolled asthma. The relevant therapeutic benefits detectable in patients with refractory eosinophilic asthma receiving mepolizumab depend on the pivotal pathogenic role played by IL-5 in these subjects. Indeed, IL-5 is the key cytokine responsible for maturation, activation, proliferation, and survival of eosinophils. Therefore, IL-5 represents a strategic molecular target for anti-eosinophilic treatments. By selectively inhibiting the biological actions of IL-5, mepolizumab provides a valuable therapeutic option for patients with severe eosinophilic asthma, refractory to standard treatments including inhaled and even systemic corticosteroids. In particular, the very important advantages linked to the use of mepolizumab in these difficult-to-treat asthmatic individuals have been well documented by several different trials performed worldwide.

Keywords: IL-5; mepolizumab; severe eosinophilic asthma.

Publication types

  • Review

MeSH terms

  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / immunology
  • Anti-Asthmatic Agents / pharmacology*
  • Anti-Asthmatic Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / immunology
  • Antibodies, Monoclonal, Humanized / pharmacology*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / immunology
  • Asthma / metabolism
  • Humans
  • Interleukin-5 / antagonists & inhibitors*
  • Interleukin-5 / immunology*
  • Pulmonary Eosinophilia / drug therapy*
  • Pulmonary Eosinophilia / immunology
  • Pulmonary Eosinophilia / metabolism

Substances

  • Anti-Asthmatic Agents
  • Antibodies, Monoclonal, Humanized
  • IL5 protein, human
  • Interleukin-5
  • mepolizumab