RESEARCH - Targeting TNF-a: A novel therapeutic approach for asthma

January 11, 2008

American Academy of Allergy, Asthma & Immunology Published by Mosby, Inc.

Received 11 September 2007; revised 15 October 2007; accepted 16 October

2007. Available online 26 November 2007.

Targeting TNF-á: A novel therapeutic approach for asthma

Brightling PhD, MRCPa, , , Mike Berry MD, MRCPb and Yassine

Amrani PhDa

aInstitute of Lung Health, University of Leicester, Leicester, United

Kingdom

bUniversity of Birmingham, Edgbaston, Birmingham, United Kingdom

Approximately 5% to 10% of patients with asthma have severe disease that is

refractory or poorly responsive to inhaled corticosteroid therapy. These

patients represent an important unmet clinical need because they experience

considerable morbidity and mortality and consume a disproportionately large

amount of health care resources. TNF-á is a proinflammatory cytokine that

has been implicated in many aspects of the airway pathology in asthma.

Evidence is emerging to suggest that it might play an important role in

severe refractory disease. The development of novel TNF-á antagonists has

allowed us to test the role of this cytokine in vivo. Preliminary studies

have demonstrated an improvement in asthma quality of life, lung function,

and airway hyperresponsiveness and a reduction in exacerbation frequency in

patients treated with anti-TNF-á therapy. However, there is marked

heterogeneity in response, suggesting that benefit is likely to be reserved

to a small subgroup. Importantly, where efficacy is reported, this also

needs to be considered in the context of concerns about the safety of

anti-TNF-á therapies. Therefore the challenge for clinicians is to evaluate

the risk/benefit ratio of these therapies in individual patients with

asthma.

er=10 & _rdoc=1 & _fmt= & _orig=search & _sort=d & view=c & _acct=C000050221 & _version=1 &

_urlVersion=0 & _userid=10 & md5=8247a23ac8223b56a845837bc4723faf

Not an MD

Recommended Posts