A Possible Explanation for Non-responders, Responders and Super-responders to Biologics in Severe Asthma

Hyland, Michael E., Masoli, Matthew, Lanario, Joseph W. and Jones, Rupert C. (2019) A Possible Explanation for Non-responders, Responders and Super-responders to Biologics in Severe Asthma. Exploratory Research and Hypothesis in Medicine, 4. pp. 35-38. ISSN 2472-0712

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Response to biologic therapies in severe asthma is variable, with patients being either nonresponders, responders or super-responders. There is currently no explanation for this variation in response. If asthma-specific inflammatory pathways are part of a wider network of pathogenic mechanisms (including systemic inflammation), then the state of this wider network could either help or hinder the effect of the biologic. People with severe asthma are often polysymptomatic with a variable frequency of nonrespiratory symptoms. Application of existing network theory would predict that high systemic inflammation, measurable by the frequency of nonrespiratory symptoms, should decrease the effectiveness of biologics, a prediction consistent with the limited existing data. A detailed examination of the relationship between biologic response and the frequency or profile of nonrespiratory symptoms would provide a testable prediction of this hypothesis. The clinical presentation of super-responders is consistent with biologics sometimes having a positive effect on the pathology (level of dysregulation) in a network system. If that were the case, then network theory predicts the possibility of a short-term increase in nonrespiratory symptoms prior to the improvement reported by super-responders. If biologics lead to less network dysregulation in some patients, then this raises the possibility of new applications for this therapy and of an improved response to biologics if lifestyle improvement is started prior to biologic therapy

Item Type: Article
Additional Information: Article also available through publisher link provided
Keywords: Severe asthma, Responder, Network, Complexity, Biologic therapy, Outcome
Depositing User: Ms Kerry Kellaway
Date Deposited: 26 Jul 2019 08:32
Last Modified: 26 Jul 2019 08:32
URI: https://marjon.repository.guildhe.ac.uk/id/eprint/17420
Related URLs: http://www.xiah ... ERHM.2019.00008 (Publisher URL)

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