Why Do Asthma Symptoms Recur? Unraveling the Mystery Behind Biologics and Relapses

Asthma, a condition marked by persistent inflammation in the airways, impacts millions globally. Though it can be managed, achieving complete control over asthma requires addressing its complex mechanisms. Biological drugs, or biologics, have revolutionized treatment for severe cases, significantly improving life quality by easing symptoms and making breathing more manageable. However, recent findings from Karolinska Institutet present a new challenge: biologics may fall short in addressing asthma’s foundational triggers, leading to potential symptom relapses post-treatment.

Research outlined in the journal Allergy sheds light on biologics’ influence on the immune system. Biologics such as mepolizumab and dupilumab target specific immune responses driving asthma’s inflammatory chain reaction. In a study involving blood samples from 40 patients, both before and during biologic therapy, researchers found that not only did some immune cells linked to inflammation persist, but their numbers occasionally increased. This discovery underscores that while symptom relief is evident, the complete eradication of the inflammatory culprits might not occur.

Valentyna Yasinska, a pulmonary medicine consultant, notes, “Biologics help most patients keep symptoms under control, but exactly how these drugs affect the immune system has so far remained unknown.” Professor Jenny Mjösberg from the tissue immunology division adds, “This suggests that biologics might not attack the root of the problem.” Continuous treatment might, therefore, be necessary to maintain control of the disease long-term.

Using state-of-the-art techniques like flow cytometry and single-cell sequencing, researchers assessed the dynamics within immune cells. Lorenz Wirth, a doctoral student involved in the research, shares his surprise at the rise in inflammatory cells, which he believes might explain why relapses occur once treatment ends. Given that biologics have been around for roughly a decade, understanding their long-term impacts on the immune system opens a promising avenue for research.

Thus, while biologics bring essential relief to those struggling with asthma, their inability to fully clear inflammation signals the need for prolonged or multifaceted treatment strategies that specifically target the disease’s root causes. Future studies are anticipated to focus on the enduring effects of biologics and involve patients with extensive treatment histories to unlock their mysteries entirely.

Key Takeaways:

1. Biologic treatments significantly benefit asthma patients by alleviating symptoms, yet may not fully eliminate the inflammatory processes at their core.
2. Certain immune cells connected to asthma inflammation can increase during biologic treatment, suggesting why relapses may happen when treatment stops.
3. Long-term treatment might be crucial for comprehensive disease management.
4. Further research is vital for a deeper understanding of the long-term effects of biologic therapies on asthma and its progression.