Pulmonology News Update: Alarmins & Emerging  Therapies in Asthma
Channel: Dr. Guru
Date: 2023-03-08

ALARMINS & ASTHMA
(Emerging Therapies): Alarmins are endogenous, constitutively expressed, chemotactic, and immune activating proteins/peptides that are released as a result of degranulation, cell injury or death, or in response to immune induction. Alarmins are involved in a variety of processes including antimicrobial gene expression regulation, cellular homeostasis, wound healing, inflammation, allergy, autoimmunity and oncogenesis. IL-25, IL-33, thymic stromal lymphopoietin (TSLP) are airway epithelial-derived alarmins and the characteristics of alarmins are that they are rapidly released after nonprogrammed cell death, they activate the immune cells. Inhibition of the effects of alarmin on the immune system are emerging therapies in the treatment of asthma. The effects of anti-IL-25 (Brodalumab) and anti-TSLP (Tezepelumab) treatments on asthmatic patients have been investigated. Brodalumab provided limited benefit only in the asthmatic group with high reversibility. Tezepelumab (now FDA approved) was found to be the first biological drug to have significant positive effect on two important indicators of asthmatic inflammation such as blood eosinophils and nitric oxide fraction in exhaled air. IL-33 blockers, astegolimab & itepekimab have not been approved by FDA as per the available info. Many other antialarmins are under investigation/experimental use.
(See references https://pubmed.ncbi.nlm.nih.gov/30246661/)