Question Regarding Non-Eosinophilic Asthma

Cindy Howard

New member
In severe non-eosinophilic asthma, are monoclonal antibodies like mepolizumab completely useless? Is epinephrine the only thing left?
 

Jaden Fisher

New member
Wait! What?

Antibodies like omalizumab (anti-IgE) and mepolizumab (anti-IL-5) are only used in severe asthma (stage 5 therapy).

Epinephrine is not used in asthma, as beta2-agonists like salbutamol are doing the bronchodilation via adrenoreceptors quite well and don't do negative side effects like vasoconstriction and tachycardia

Why would they be useless ? Mepolizumab reduces the number of eosinophils in the blood.
 

Jaden Fisher

New member
Hmmm. I don't know.

Most asthmas are allergic asthmas.

No, the antibodies are just for allergic asthmas.

So they wouldn't be used for non-allergic asthma.

Apparently there is also a differentiation between severe allergic asthma and severe eosinophilic asthma.
 

Cindy Howard

New member
Is a "combined" asthma possible? Like normally low eosinophils asthma but if another allergic reaction occurs (like latex reaction) asthma is triggered?
 

Jaden Fisher

New member
Depending on the TH2-cell activity.

Both allergic and eosinophilic have high TH2-cell activity, while neutrophilic asthma doesn't.

So omalizumab is for severe allergic asthma, and mepolizumab and reslizumab for severe eosinophilic asthma.

So non eosinophilic, allergic asthma: omalizumab would be fine.

Of course! That's only for severe (stage 5 therapy)
 

Jaden Fisher

New member
I would say that it would be eosinophilic asthma, if you have "both". Because the allergic is basically eosinophilic with less eosinophils.
 

Cindy Howard

New member
Depending on the TH2-cell activity.

Both allergic and eosinophilic have high TH2-cell activity, while neutrophilic asthma doesn't.

So omalizumab is for severe allergic asthma, and mepolizumab and reslizumab for severe eosinophilic asthma.

So non eosinophilic, allergic asthma: omalizumab would be fine.

Of course! That's only for severe (stage 5 therapy)
Stage 5?
 

Jaden Fisher

New member
Epinephrine or norepinephrine is used in anaphylactic shocks or angio-edema.

But for just bronchodilation, if you only need the bronchodilation, there is no benefit in using epinephrine, even salbutamol and stuff you can give intravenously.
 
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