Emerging monoclonal antibodies as targeted innovative therapeutic approaches to asthma

Asthma is characterized by discordant responses among cells of the adaptive and innate immune systems. This interplay involves a complex pattern of cytokine‐driven processes resulting in cell migration and recruitment, inflammation, and proliferative states. The significant majority of asthmatic patients respond well to conventional inhaled treatments. However, about 5% of asthmatics have severe refractory asthma and account for 50% of the health expenditure on asthma. Human(ized) monoclonal antibodies (hMabs) targeting inflammatory pathways are promising therapeutic agents in asthma management. The anti‐IgE hMab omalizumab was the first biologic treatment approved for the treatment of allergic asthma. Potential future strategies and targets include interleukin (IL)‐5, IL‐4, and IL‐13, anti‐TSLP, IL‐25, and IL‐33. hMabs targeting IL‐5 have shown great promise in severe refractory asthma with a persisting eosinophilia, and clinical trials with hMabs against IL‐13 and IL4Rα have also shown clinical benefit. Studies of hMabs against other cytokines in severe asthma are under way.