Targeting Mast Cells in the Treatment of Severe Asthma

Allergies & Asthma


Many patients with severe asthma have difficulty in controlling symptoms with standard treatment consisting of high dose steroid inhalers or steroid tablets. A recent study published in the New England Journal of Medicine investigated the use and effect of the drug Imatinib on airway hyper responsiveness and mast cell quantities in patients with severe asthma.

Severe asthma is characterized by airway hyper responsiveness, which means that the lungs reaction to a constriction stimulus is overemphasized. Asthma is a lung condition in which individuals have difficulty breathing and experience symptoms such as wheezing and coughing. Past studies have shown that patients with severe asthma have airway hyper responsiveness and an increased level of mast cells within the body. Mast cells are commonly found in tissues following periods of inflammation. Currently, there is no cure for asthma which means the aim of treatment is to manage symptoms and slow the progression of the disease.

For many asthmatic patients who develop a severe form of the disease, managing their condition can be challenging with current treatments that have only limited effectiveness. The hypothesis of a recent study published in the New England Journal of Medicine was that by inhibiting the KIT receptor, a drug called Imatinib could decrease the level of mast cells and airway hyper responsiveness in the lungs of patients with severe asthma. The hypothesis was tested in patients whose asthma was not controlled with standard treatment.

Results of the study showed that Imatinib, a KIT receptor inhibitor, decreased not only the number of mast cells but also their activation. The drug only modestly decreased airway hyper responsiveness and improved lung function. Unfortunately, the study also reports that Imatinib caused adverse effects that were resolved only after stopping treatment. The authors highlighted this issue and state that it must be considered and investigated in the future research.

The study shows that KIT receptor inhibition decreases the number of mast cells and mast cell activation, while modestly improving airway hyper responsiveness and lung function in patients with severe asthma. Further research is needed to investigate drugs, such as Imatinib, that work by limiting mast cell production by inhibiting the KIT receptor; and the consequences of this on the management of patients with severe asthma.

Written By: Jade Marie Evans, MPharm, Medical Writer

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