The researchers, headed by Professor Stephen Holgate, MRC Clinical Professor of Immunopharmacology at Southampton, have shown that a small inflammatory protein – tumour necrosis factor alpha (TNFa) – is generated in very high levels by the lungs of severe asthmatics despite their high use of available asthma treatments.

This observation led to a pilot study, involving 15 asthmatic patients, to block the inflammatory protein with the biological agent etanercept (Enbrel) that binds to TNFa and prevents its actions.

“Many of the patients voluntarily stopped their regular nebulised bronchodilator and all gained considerable improvements in asthma symptoms, lung function and quality of life. On completing the trial, patients wanted to continue with the therapy,” said Professor Holgate.

“This study is the first to demonstrate a key role for TNFa in chronic asthma which had previously been considered as a largely allergic disorder. The remarkable clinical benefit achieved with etanercept mirrors that achieved with this therapy in other chronic inflammatory disease such as rheumatoid arthritis, inflammatory bowel disease and psoriasis,” he added.

Etanercept along with humanised blocking antibodies is finding wide use in patients with severe debilitating inflammatory diseases. Chronic asthma can now be added to these. One of the most important abnormalities in asthma is the “twitchiness” of the airways that narrow with the least provocation. This hyperresponsiveness was reversed by the 12-week etanercept treatment.

“Although our study was uncontrolled, a recent placebo-controlled study in Leicester has replicated the findings. Large international multicentre studies are now underway in phase 3 clinical trials,” he added.

MEDICA.de; Source: University of Southampton