Biologics and Allergy

Proteins

Proteins useful for the treatment of diseases include a small number of naturally-occurring proteins called cytokines. Cytokines are proteins which the body uses to both activate and suppress immune cells which are involved in immune regulation and protection against infections. Interleukin-2 (Aldesleukin) is an approved therapy for certain cancers, while interferon gamma and interferon alpha are used as treatments for specific types of infectious illnesses and immunodeficiency states. Monoclonal antibodies, or MAbs, are laboratory-produced antibodies that target specific proteins that are involved in disease processes. 

There are 2 major inflammatory pathways that drive allergic diseases: Type-2 (Th-2) inflammation and non-type 2 inflammation. All of the biologic medications currently approved for use, and most of the biologic medications under development for allergic diseases have focused on the Th-2 inflammatory pathway. Biologic targets along this pathway include Anti-Immunoglobulin E (IgE), Anti-Interleukin -5 (IL-5), Anti-IL 4, and Anti-IL-13. Although the most study has been done in the realm of severe asthma, biologic targets for other allergic diseases including atopic dermatitis, chronic rhino sinusitis with nasal polyposis, chronic idiopathic urticarial, eosinophilic esophagitis, and eosinophilic granulomatosis with polyangiitis are also there. 

Some of the biologic therapies used in various diseases include:-

Asthma

Biologic agents developed for asthma therapy have focused on the type 2–high pattern of inflammation, probably because there are more readily available biomarkers that one can measure to identify these patients (e.g., blood eosinophils). Patients with type 2–low asthma are more difficult to characterize and identify, and type 2–low asthma is often described as asthma with the absence of type 2–high characteristics.