Assessing response to biological therapies in severe asthma.

IF 3.7 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2026-04-03 DOI:10.1080/1744666X.2026.2655162

Angelantonio Maglio, Carolina Vitale, Luisa Oriana D'Auria, Valeria Longobardi, Antonio Franzese, Corrado Pelaia, Girolamo Pelaia, Alessandro Vatrella

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引用次数: 0

Abstract

Introduction: The management of severe asthma has shifted toward precision medicine, with clinical remission emerging as the ultimate therapeutic goal. This review evaluates the transition from predicting treatment response to achieving sustained remission through biologics.

Areas covered: A comprehensive literature search was conducted in PubMed and Embase for articles published between January 2015 and February 2026. Keywords included 'severe asthma,' 'biologic therapies,' 'clinical remission,' and 'T2 biomarkers.' We analyze the predictive value of blood eosinophils (BEC), FeNO, and emerging indicators like CT-based mucus plugs. The review synthesizes data on 'super-responders' and the integration of real-world evidence into clinical practice.

Expert opinion: Achieving clinical remission requires a multidimensional assessment beyond symptom control, including lung function stability and OCS elimination. Future management will likely focus on 'disease modification' and early biologic intervention. The identification of specific phenotypes, such as those with high mucus-plug burdens, will allow for more tailored therapy. However, standardized criteria for 'remission off-treatment' remain the primary challenge for the next decade of respiratory research.

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评估严重哮喘患者对生物疗法的反应。

简介：重症哮喘的治疗已经转向精准医学，临床缓解成为最终的治疗目标。本综述评估了从预测治疗反应到通过生物制剂实现持续缓解的转变。覆盖领域：在PubMed和Embase中对2015年1月至2026年2月间发表的文章进行了全面的文献检索。关键词包括“严重哮喘”、“生物疗法”、“临床缓解”和“T2生物标志物”。我们分析了血嗜酸性粒细胞（BEC）、FeNO和基于ct的粘液塞等新兴指标的预测价值。该综述综合了“超级应答者”的数据，并将真实世界的证据整合到临床实践中。专家意见：实现临床缓解需要在症状控制之外的多维评估，包括肺功能稳定性和OCS消除。未来的治疗可能侧重于“疾病改良”和早期生物干预。对特定表型的识别，例如那些具有高粘液堵塞负担的表型，将允许更有针对性的治疗。然而，“治疗缓解”的标准化标准仍然是未来十年呼吸研究的主要挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.