Imunobiológicos em doenças alérgicas – desafios e novos rumos
Biologics in allergic diseases – challenges and new directions
Sergio Duarte Dortas-Junior; Norma de Paula M. Rubini; Filipe Wanick Sarinho; Aldo José Fernandes Costa; Eduardo Costa Silva; Fabrício Prado Monteiro; Marta de Fátima Rodrigues da Cunha Guidacci; Martti Anton Antila; Ekaterini Simões Goudoris; Fabio Chigres Kuschnir; João Negreiros Tebyriça; Nelson Augusto Rosario-Filho
Resumo
O desenvolvimento e a disponibilização do primeiro anticorpo monoclonal para o tratamento da asma, ocorrido há duas décadas, deu início a uma nova era no tratamento das doenças alérgicas. Desde então, novas terapias foram experimentadas com sucesso utilizando-se anticorpos monoclonais direcionados contra as principais citocinas envolvidas nas reações alérgicas tipo 2 ou os seus receptores, possibilitando o controle de diversas desordens imunoalérgicas como asma, dermatite atópica, esofagite eosinofílica, granulomatose eosinofílica com poliangeíte, rinossinusite crônica com pólipos nasais, síndromes hipereosinofílicas e urticária crônica espontânea. Os avanços científicos, ao mesmo tempo que trazem respostas, levantam novas questões. O presente artigo procura discutir e aprofundar estas questões como, por exemplo, o uso combinado de imunobiológicos, o conceito de remissão clínica, a potencial influência sobre a marcha atópica e as possibilidades terapêuticas que se descortinam com os ensaios clínicos de novos biológicos para as doenças imunoalérgicas.
Palavras-chave
Abstract
The introduction of the first monoclonal antibody for asthma treatment two decades ago marked the beginning of a new era in the management of allergic diseases. Since then, new therapies using monoclonal antibodies targeting cytokines involved in type II hypersensitivity reactions or their receptors have been successfully developed, allowing control of several immunoallergic disorders, including asthma, atopic dermatitis, eosinophilic esophagitis, eosinophilic granulomatosis with polyangiitis, chronic rhinosinusitis with nasal polyps, hypereosinophilic syndrome, and chronic spontaneous urticaria. While scientific advances provide important answers, they also raise new questions. The objective of this article was to discuss and explore these issues, including the combined use of biologics, the concept of clinical remission, their potential influence on the atopic march, and the therapeutic possibilities emerging from clinical trials of new biologics for immunoallergic diseases.
Keywords
References
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Submitted date:
11/24/2024
Accepted date:
12/21/2024
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