Cytokine therapeutics for asthma: An appraisal of current evidence and future prospects

Although current pharmacopoeia is effective in alleviating asthma symptomat ology, it is equally unable to modify the fundamental immunological basis o f the allergic diathesis. The explosion in knowledge of the immunobiology o f cytokines that has occurred in the last decade has remarkably clarified o ur understanding of the pathogenesis of allergic asthma, and has unleashed a plethora of compelling opportunities. In the first part of this review, w e will summarize current knowledge on the pathogenesis of allergic asthma, with particular emphasis on relevant cytokine networks. This will position us to appraise critically initiatives in the search to modulate cytokine ta rgets that are key to the expression of the allergic asthma phenotype. We w ill review the use of recombinant cytokines, soluble cytokine receptors, cy tokine receptor antagonists and cytokine inhibitors, in pre-clinical and cl inical development. Finally, we will assess the applicability of transgene- based modalities, including anti-sense oligonucleotide technology and gene therapy, as novel therapeutic strategies in the treatment of allergic asthm a.