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not-yet-known not-yet-known not-yet-known unknown Biologics and Airway Remodeling in Asthma: Early, Late and Potential Preventive Effects
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  • Gilda Varricchi,
  • Remo Poto,
  • Lommatzsch M.,
  • Guy Brusselle,
  • Fulvio Braido,
  • Christian Virchow,
  • Walter Canonica
Gilda Varricchi
Universita degli Studi di Napoli Federico II Dipartimento di Scienze Mediche Traslazionali
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Remo Poto
Universita degli Studi di Napoli Federico II Dipartimento di Scienze Mediche Traslazionali
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Lommatzsch M.
Universitatsmedizin Rostock Abteilung Pneumologie und Interdisziplinare Internistische Intensivmedizin
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Guy Brusselle
Ghent University Hospital
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Fulvio Braido
IRCCS Polyclinic Hospital San Martino
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Christian Virchow
Universitatsmedizin Rostock Abteilung Pneumologie und Interdisziplinare Internistische Intensivmedizin

Corresponding Author:[email protected]

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Walter Canonica
IRCCS Polyclinic Hospital San Martino
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Abstract

Although airway remodeling in severe and/or fatal asthma is still considered irreversible, its individual components as a cause of clinical symptoms and/or lung function changes remain largely unknown. While inhaled glucocorticoids have not consistently been shown to affect airway remodeling, biologics targeting specific pathways of airway inflammation have been shown to improve lung function, mucus plugging, and airway structural changes that can exceed those seen with glucocorticoids. This superiority of biologic treatment, which cannot be solely explained by insufficient doses or limited durations of glucocorticoid therapies, needs to be further explored. For this field of research, we propose a novel classification of the potential effects of biologics on airway remodeling into 3 temporal effects: early effects (days to weeks, primarily modulating inflammatory processes), late effects (months to years, predominantly affecting structural changes) and potential preventive effects (outcomes of early treatment with biologics). For the identification of potential preventive effects of biologics, we call for studies exploring the impact of early biological treatment on airway remodeling in patients with moderate-to-severe asthma, which should be accompanied by a long-term evaluation of clinical parameters, biomarkers, treatment burden, and socioeconomic implications.
25 Aug 2024Submitted to Allergy
27 Aug 2024Submission Checks Completed
27 Aug 2024Assigned to Editor
27 Aug 2024Review(s) Completed, Editorial Evaluation Pending
29 Aug 2024Reviewer(s) Assigned
12 Sep 2024Editorial Decision: Revise Minor
30 Sep 20241st Revision Received
03 Oct 2024Submission Checks Completed
03 Oct 2024Assigned to Editor
03 Oct 2024Review(s) Completed, Editorial Evaluation Pending
10 Oct 2024Reviewer(s) Assigned
23 Oct 2024Editorial Decision: Accept