Biologic treatments are changing how providers think about caring for patients with asthma and allergies, reports Pulmonary Advisor.

Omalizumab is a monoclonal antibody with a high binding affinity for IgE that has demonstrated good efficacy against asthma and allergic conditions such as AD, reducing the frequency, severity, and chronicity of symptoms by inhibiting the T2 inflammatory action of IgE.3 Omalizumab is considered an appropriate add-on therapy for patients with uncontrolled allergic asthma, as well as those with chronic urticaria.

The IL-4 and IL-13 pathways have been implicated in the production of inflammatory eosinophils in allergic diseases; IL-4 cytokines contribute to IgE mechanisms and hepatic proliferation, whereas IL-13 has effects that are limited mostly to barrier dysfunction and biological disturbances of the skin. Dupilumab is a monoclonal antibody that works as a dual inhibitor of IL-4 and IL-13 signaling. It has been approved for the add-on treatment of uncontrolled eosinophilic asthma, AD, and chronic rhinosinusitis with nasal polyps.

Expression of eosinophils has a particularly strong association to asthma by contributing to inflammatory obstruction. The protein granules in eosinophils can also cause irritation to the airway structure and trigger bronchial spasm. Cytokines such as IL-5 produced by eosinophils may also stimulate new eosinophil formation to promote an ongoing cycle of airway dysfunction.