The epithelium, once simply considered a protective barrier against harmful agents, has in recent times gained considerable relevance as an entity that can promote and regulate inflammatory processes through the production of cytokines, namely interleukin (IL)-25, IL-33 and thymic stromal lymphopoietin (TSLP), known as "alarmins". TSLP, in particular, has been extensively studied as a possible therapeutic target in patients with severe asthma because it is involved in the inflammatory processes of both type 2-high and type 2-low inflammation. In this regard, tezepelumab (AMG-157/MEDI-9929), a TSLP-targeted first-in-class fully human monoclonal antibody, has been shown in phase II and III studies to be effective and safe in treating patients with severe asthma, regardless of the underlying endotype or phenotype and irrespective of baseline biomarkers, such as blood eosinophil count and fraction of exhaled nitric oxide. Here, we provide a comprehensive review of TSLP function in airway inflammatory processes, the clinical development of tezepelumab for severe asthma as well as its possible future indications.
Keywords: Airway inflammatory processes; Asthma; Severe asthma; Tezepelumab; Thymic stromal lymphopoietin (TSLP); Upper respiratory tract disorders.
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