嚴重嗜酸性白血球氣喘為嚴重氣喘臨床表現型的一種，其特徵在於反覆發作、 疾病控制不佳及嗜酸性白血球炎症。在過去幾年內，一些分子生物標記和訊息傳遞路徑已成為治療嚴重嗜酸性白血球氣喘的合適生物製劑之作用標的。實際上，目前已有各種治療性單株抗體核准用於阻斷嗜酸性白血球引起呼吸道發炎之致病路徑。 Mepolizumab 和 reslizumab 為介白素 5 (interleukin-5, IL-5) 拮抗劑，可避免 IL-5 和其受體 (IL-5R) 相互作用和減少嗜酸性白血球過度被製造。Benralizumab 為選擇性 IL-5R 拮抗劑。此外，dupilumab 為介白素 4 (interleukin-4, IL-4) 和介白素 13 (interleukin-13, IL-13) 雙重受體拮抗劑。於這些新的治療選擇下，可提供更好的臨床反應和實踐精準醫療。本文回溯生物製劑用於治療嚴重嗜酸性白血球的相關文獻，瞭解其藥物特性與治療的策略。

 

Severe eosinophilic asthma is a clinically recognized phenotype of severe asthma characterized by recurrent exacerbations, poor disease control, and eosinophilic inflammation. During the last years several molecular effectors and signaling pathways have emerged as suitable targets for biological therapies of severe eosinophilic asthma, refractory to standard treatments. Indeed, various therapeutic monoclonal antibodies currently allow to intercept at different levels the chain of pathogenic events leading to eosinophilic airway inflammation. Mepolizumab or reslizumab inhibits interleukin 5 (IL–5), thus preventing its interaction with IL–5 receptor and reducing the signal for excess production of eosinophils. Benralizumab is a selective blocker of IL–5 receptor. Moreover, dupilumab behaves as a dual receptor antagonist of interleukins 4 (IL–4) and 13 (IL–13). These new therapeutic options make it possible to lead to better clinical responses and implement precision medicine. The purpose of this article is to provide a comprehensive overview of the current use of biologics concerning drug properties and treatment strategies.

 

Summited for publication: 2021.10.27; Accepted for publication: 2022.4.20