The New Therapeutic Frontiers in the Treatment of Eosinophilic Esophagitis: Biological Drugs

Eosinophilic esophagitis (EoE) is a multifaceted disease characterized by a wide heterogeneity of clinical manifestations, endoscopic and histopathologic patterns, and responsiveness to therapy. From the perspective of an effective approach to the patient, the different inflammatory mechanisms invol...

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Bibliographic Details
Published in:International journal of molecular sciences 2024-02, Vol.25 (3), p.1702
Main Authors: Ridolo, Erminia, Barone, Alessandro, Ottoni, Martina, Peveri, Silvia, Montagni, Marcello, Nicoletta, Francesca
Format: Article
Language:English
Subjects:
benralizumab
biological drugs
Biological products
cendakimab
Collagen
Cytokines
Disease
Drug approval
dupilumab
Endoscopy
eosinophilic esophagitis
Esophagitis
Esophagus
FDA approval
Fibroblasts
Genes
Health aspects
Hyperplasia
Inflammation
Interleukins
lirentelimab mepolizumab
Medical research
Monoclonal antibodies
Pathogenesis
Proteins
Smooth muscle
Steroids
Tumor necrosis factor-TNF
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Summary:Eosinophilic esophagitis (EoE) is a multifaceted disease characterized by a wide heterogeneity of clinical manifestations, endoscopic and histopathologic patterns, and responsiveness to therapy. From the perspective of an effective approach to the patient, the different inflammatory mechanisms involved in the pathogenesis of EoE and biologics, in particular monoclonal antibodies (mAbs), targeting these pathways are needed. Currently, the most relevant is dupilumab, which interferes with both interleukin (IL)-4 and IL-13 pathways by binding IL-4 receptor α, and is the only mAb approved by the European Medicine Agency and US Food and Drug Administration for the treatment of EoE. Other mAbs investigated include mepolizumab, reslizumab, and benralizumab (interfering with IL-5 axis), cendakimab and dectrekumab (anti-IL-13s), tezepelumab (anti-TSLP), lirentelimab (anti-SIGLEG-8), and many others. Despite the undeniable economic impact of biologic therapies, in the near future, there will be room for further reflection about the opportunity to prescribe biologic agents, not only as a last-line therapy in selected cases such as patients with comorbidities involving common pathways. Although recent findings are very encouraging, the road to permanent success in the treatment of EoE is still long, and further studies are needed to determine the long-term effects of mAbs and to discover new potential targets.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms25031702