Immune response modifiers in the treatment of asthma: A PRACTALL document

Immune response modifiers in the treatment of asthma: A PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology

• Mark Ballow, MD
, 
• Cezmi A. Akdis, MD
, 
• Thomas B. Casale, MD
, 
• Andrew J. Wardlaw, MD
, 
• Sally E. Wenzel, MD
, 
• Zuhair Ballas, MD
, 
• Jan Lötvall, MD

Received 5 April 2012; accepted 9 April 2012. published online 19 June 2012.

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Article Outline

• IRMs that neutralize effector molecules
• IRMs that affect the TH2 pathway
• Interruption of the IL-4, IL-13, and IL-4Rα pathways
• Anti–IL-5
• Modulation of the chemoattractant receptor-homologous molecule expressed on TH2 cells receptor
• Antagonists of adhesion and chemokine pathways controlling eosinophil and TH2 lymphocyte migration
• IL-9 and more recently described TH2-associated cytokines
• Inhibition of T cells and their coreceptors
• IRMs that affect signaling pathways
  • Calcineurin inhibitors
  • Tyrosine kinase inhibitors
  • Other kinase inhibitors
• Peroxisome proliferator-activated receptor agonists
• IRMs as adjuvants for allergen immunotherapy
• Adverse events of IRMs
• The future of IRMs
• Summary
• References
• Copyright

Key words: Immune response modifiers, monoclonal antibodies, asthma, allergic diseases

Abbreviations used: APC, Antigen-presenting cell, CRTH2, Chemoattractant receptor-homologous molecule expressed on T_H2 cells (also known as DP₂), FDA, US Food and Drug Administration, Feno, Fraction of exhaled nitric oxide, IL-4R, IL-4 receptor, IRM, Immune response modifier, MPLA, Monophosphoryl lipid A, PAMP, Pathogen-associated molecular pattern, PPAR, Peroxisome proliferator-activated receptor,Syk, Spleen tyrosine kinase, TKI, Tyrosine kinase inhibitor, TLR, Toll-like receptor, VLA-4, Very late antigen 4