Anticorpos monoclonais no tratamento da asma
Monoclonal antibodies in asthma treatment
Rosana C. Agondi; Marcelo V. Aun; Carla Bisaccioni; Jorge Kalil; Adelmir de Souza Machado; Alfeu T. França; Eduardo Costa; Flávio Sano; Gustavo F. Wandalsen; José Angelo Rizzo; Pedro Giavina-Bianchi
Resumo
Objetivo: Revisar a aplicação dos principais anticorpos monoclonais já utilizados em estudos clínicos de asma, bem como detalhar os que já estão disponíveis para uso clínico.
Fontes de dados: Artigos originais indexados nos bancos de dados MEDLINE e LILACS de janeiro de 1975 a dezembro de 2011, nos idiomas português e inglês, e livros-textos selecionados.
Síntese dos dados: Os principais anticorpos monoclonais já estudados no tratamento da asma são os antagonistas de algumas citocinas de perfil TH2 (anti-IL-4, Anti-IL-5, Anti-IL-9 e Anti-IL-13) e da IgE (anti-IgE), embora outros anticorpos, como anti-TNF e anti-CD11a, já tenham sido pesquisados.
Conclusões: Embora diversos anticorpos monoclonais já tenham sido utilizados na pesquisa clínica em asma, apenas o omalizumabe (anti-IgE) está disponível comercialmente, porque há evidências demonstrando sua eficácia.
Palavras-chave
Abstract
Objective: To review the application of the main monoclonal antibodies which have already been used in clinical studies of asthma, as well as detailing those already available for clinical practice.
Sources: Original articles indexed in the databases MEDLINE and LILACS January 1975 to December 2010, Languages: Portuguese and English and selected textbooks.
Data synthesis: The main monoclonal antibodies which have already been studied for asthma are cytokines TH2 antagonists (anti-IL-4, AntiIL-5, Anti-IL-9 e Anti-IL-13) and IgE antagonist (anti-IgE), although other antibodies, as anti-TNF and anti-CD11a, have already been utilized.
Conclusions: Despite the fact that many monoclonal antibodies have been utilized in asthma clinical research, only omalizumab (anti-IgE) is commercially available, because many studies have shown its efficacy.
Keywords
Referências
1. Weiner LM, Surana R, Wang S. Monoclonal antibodies: versatile platforms for cancer immunotherapy. Nature Rev Immunology 2010;10:317-27.
2. Köhler G, Milstein C. Continuous cultures of fused cells secreting antibody of predefined specificity. Nature 1975;256:495-7.
3. Berger M, Shankar V, Vafai A. Therapeutic applications of monoclonal antibodies. Am J Med Sci 2002;324:14-30.
4. Kelley KW, Lewin HA. Monoclonal antibodies: pragmatic application of immunology and cell biology. J Anita Sci 1986;63:288-309.
5. Weiner LM. Fully human therapeutic monoclonal antibodies. J Immunother 2006;29:1-9.
6. Goodin S. Development of monoclonal antibodies for the treatment of colorectal cancer. Am J Health Syst Pharm 2008;65:S3-7.
7. h t t p : / / w w w . w h o . i n t / m e d i c i n e s / s e r v i c e s / i n n / Generalpoliciesformonoclonalantibodies2009.pdf. Acessado: 28 de Fevereiro de 2012.
8. Barnes PJ. New therapies for asthma: is there any progress? Trends Pharmacol Sci 2010;31:335-43.
9. Corren J, Busse W, Meltzer EO, Mansfield L, Bensch G, Fahrehholz J, et al. A randomized, controlled, phase 2 study of AMG 317, an IL-4Ralpha antagonist, in patients with asthma. Am J Respir Crit Care Med 2010;181:788-96.
10. Molfino NA, Gossage D, Kolbeck R, Parker JM, Geba GP. Molecular and clinical rationale for therapeutic targeting of interleukin-5 and its receptor. Clin Exp Allergy 2012;42:712-37.
11. Busse WW, Ring J, Huss-Marp J, Kahn JE. A review of treatment with mepolizumab, an anti–IL-5 mAb, in hypereosinophilic syndromes and asthma. J Allergy Clin Immunol 2010;125:803-13.
12. Haldar P, Brightling C, Hargadon B, Gupta S, Monteiro W, Sousa A, Marshall RP, Bradding P, Green R, Wardlaw A, Pavord I. Mepolizumab and exacerbations of refractory eosinophilic asthma. N Engl J Med 2009;360:973-84.
13. Leckie MJ, Brinke A, Khan J, Diamant Z, O’Connor BJ, Walls CM, et al. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response. Lancet 2000;356:2144-8.
14. Kips JC, O’Connor BJ, Langley SJ, Woodcock A, Kerstjens HA, Postma DS, et al. Effect of SCH55700, a humanized anti-human interleukin-5 antibody, in severe persistent asthma: a pilot study. Am J Respir Crit Care Med 2003;167:1655-9.
15. Flood-Page P, Swenson C, Faiferman I, Matthews J, Williams M, Brannick L, et al. A study to evaluate safety and efficacy of mepolizumab in patients with moderate persistent asthma. Am J Respir Crit Care Med 2007;176:1062-71.
16. Castro M, Marthur S, Hargreave F, Boulet LP, Xie F, Young J, et al. Reslizumab for poorly controlled, eosinophilic asthma: a randomized, placebo-controlled study. Am J Respir Crit Care Med 2011;184:1125-32.
17. Busse WW, Katial R, Gossage D, Sari S, Wang B, Kolbeck R. Safety profile, pharmacokinetics, and biologic activity of MEDI-563, an anti-IL-5 receptor alpha antibody, in a phase I study of subjects with mild asthma. J Allergy Clin Immunol 2010;125:1237-44.
18. Oh CK, Raible D, Geba GP, Molfino NA. Biology of the interleukin-9 pathway and its therapeutic potential for the treatment of asthma. Inflamm Allergy Drug Targets 2011;10:180-6.
19. Parker JM, Oh CK, LaForce C, Miller SD, Peralman DS, Le C, et al. Safety profile and clinical activity of multiple subcutaneous doses of MEDI-528, a humanized anti-interleukin-9 monoclonal antibody, in two randomized phase 2a studies in subjects with asthma. BMC Pulm Med 2011;11:14.
20. Corren J, Busse W, Meltzer EO, Mansfield L, Bensch G, Fahrehholz J, et al. A randomized, controlled, phase 2 study of AMG 317, an IL-4Ralpha antagonist, in patients with asthma. Am J Respir Crit Care Med 2010;181:788-96.
21. Corren C, Lemanske, Jr RF, Hanania NA, Korenblat PE, Parsey MV, Arron JR et al. Lebrikizumab treatment in adults with asthma. N Eng J Med 2011;365:1088-98.
22. Abbas AK, Lichtman AH, Pillai S. Imunidade aos microrganismos, In: Imunologia Celular e Molecular. Rio de Janeiro: Ed. Elsevier 2005: p. 351-73.
23. Camelo-Nunes IC. IgE e inflamação alérgica, In: Sole D & Daher S. IgE – da síntese à prática clínica. Ed.1. Rosconi 2008. p. 36-46.
24. Musatti, CC. IgE, da síntese à prática clínica. São Paulo: Rosconi, 2007: p23-33.
25. Prussin C, Metcalfe DD. IgE, mast cells, basophils, and eosinophils. J Allergy Clin Immunol 2006;117:S450-6.
26. Kisselgof AB, Oettgen HC. The expression of murine B cell CD23, in vivo, is regulated by its ligand, IgE. Int Immunol 1998;10:1377-84.
27. Arshad SH, Holgate S. The role of IgE in allergen-induced inflammation and the potential for intervention with a humanized monoclonal anti-IgE antibody. Clin Exp Allergy 2001;31:1344-51.
28. Strunk RC, Bloomberg GR. Omalizumab for asthma. N Eng J Med 2006;354:2689-95.
29. Holgate ST, Polosa R. Treatment strategies for allergy and asthma. Nature Rev 2008;8:218-30.
30. Belliveau PP, Lahoz MR. Evaluation of Omalizumab from a health plan perspective. J Manag Care Pharm 2005;11:735-45.
31. European Medicines Agency; Science Medicines Health. Disponível em: http://www.ema.europa.eu/docs/en_GB/document_library/ PIP_decision/WC500095976.pdf. Acessado em 24 de fevereiro de 2012.
32. Kopp MV, Hamelmannw E, Zielenz S, Kamin W, Bergmannz K-C, Siederk C, et al. Combination of omalizumab and specific immunotherapy is superior to immunotherapy in patients with seasonal allergic rhinoconjunctivitis and co-morbid seasonal allergic asthma. Clin Exp Allergy 2008;39:271-9.
33. Fitzhugh DJ, Lockey RF. Allergen immunotherapy: a history of the first 100 years. Curr Opin Allergy Clin Immunol 2011;11:554-9.
34. Vichyanond P. Omalizumab in allergic diseases, a recent review. Asian Pac J Allergy Immunol 2011;29:209-19.
35. Tillie-Leblond I, Germaud P, Leroyer C, Tétu L, Girard F, Devouassoux G, et al. Allergic bronchopulmonary aspergillosis and omalizumab. Allergy 2011;66:1254-6.
36. Wenzel SE, Barnes PJ, Bleecker ER, Bousquet J, Busse W, Dahlén SE, et al. A randomized, double-blind, placebo-controlled study of tumor necrosis factor-alpha blockade in severe persistent asthma. Am J Respir Crit Care Med 2009;179:549.
37. Morjaria JB, Chauhan AJ, Babu KS, Polosa R, Davies DE, Holgate ST. The role of a soluble TNFalpha receptor fusion protein (etanercept) in corticosteroid refractory asthma: a double blind, randomised, placebo controlled trial. Thorax 2008;63:584.
38. Gauvreau GM, Becker AB, Boulet LP, Chakir J, Fick RB, Greene WL, et al. The effects of an anti-CD11a mAb, efalizumab, on allergeninduced airway responses and airway inflammation in subjects with atopic asthma. J Allergy Clin Immunol 2003;112:331-8.
39. Busse WW, Israel E, Nelson HS, Baker JW, Charous BL, Young DY, et al. Daclizumab improves asthma control in patients with moderate to severe persistent asthma: a randomized, controlled trial. Am J Respir Crit Care Med 2008;178:1002-8.
Submetido em:
03/09/2012
Aceito em:
25/10/2012
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