Targeting airway remodeling
Experimental and human studies have demonstrated that glucocorticoids and certain anti-inflammatory drugs can reduce inflammation and morbidity in mild to moderate asthma. However, evidences of beneficial effects of glucocorticoids on airway remodeling have not been demonstrated, with several reports showing contradictory results17, 113, 114. The introduction of several biological immunotherapies (e.g., anti-IgE, anti-IL-5/IL-5Rα, anti-IL-4Rα, anti-TSLP)2, 115 has favored the development of a personalized medicine approach for the treatment of patients with severe asthma 116-119. There is some evidence that these biologics can improve not only clinical symptoms but also certain features of airway remodeling and functional decline of FEV1. Therefore, it will be important to evaluate the effects of biological immunotherapies in randomized clinical trials (RCTs) and real-life settings120, 121.