Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press140810.36691/RJA1408ReviewsНаучные обзорыReview ArticleDupilumab: new opportunities for the treatment of asthma and chronic rhinosinusitis with nasal polypsДупилумаб: новые возможности в терапии бронхиальной астмы и полипозного риносинуситаhttps://orcid.org/0000-0003-1965-844657214749322D-1943-20199504-0251DynevaMiramgul E.ДыневаМирамгуль Есенгельдыевна
Russian Federation

MD, junior researcher

младший научный сотрудник

amanturliva.miramgul@mail.ruhttps://orcid.org/0000-0002-7139-4882AminovaGulyumkhan E.АминоваГулюмхан Эльвировна
Russian Federation
79263037827@yandex.ruhttps://orcid.org/0000-0003-3250-06945698-6436KurbachevaOksanaКурбачеваОксана Михайловна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

kurbacheva@gmail.comhttps://orcid.org/0000-0002-3556-969X6715-5650Il'inaNatalya I.ИльинаНаталья Ивановна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

instimmun@yandex.ruNational Research Center — Institute of Immunology Federal Medical-Biological Agency of RussiaГосударственный научный центр «Институт иммунологии» Федерального медико-биологического агентства180220211503202118118312611202001022021Copyright ©; 2021, Pharmarus Print MediaCopyright ©; 2021, Фармарус Принт Медиа2021Pharmarus Print MediaФармарус Принт Медиаhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://rusalljournal.ru/raj/article/view/1408

Airway inflammation plays a crucial role in the development of asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). The severity of inflammation influences the clinical picture of the disease and, most importantly, the effectiveness of therapy.

To date, the growth in the incidence rate of asthma and CRSwNP is still high and the effectiveness of existing therapy for severe asthma, especially associated with CRSwNP, is unsatisfactory. Therefore, the aim is to investigate novel diagnostic tools and therapies.

The emergence of biologics that target specific inflammatory pathways is a promising step forward to achieve control of severe uncontrolled asthma and recurrent CRSwNP. Dupilumab is one of recently introduced monoclonal antibodies, which has shown significant advances in the treatment of asthma and CRSwNP.

Dupilumab is a fully human monoclonal antibody targeted to interleukin-4 receptor alpha subunit (IL-4Rα) that is a receptor for both IL-4 and IL-13. Thus, it helps to inhibit cytokine T2-signaling (IL-4 and IL-13), since the IL-4/IL-13/STAT6 signaling pathway plays a crucial role in T2-inflammation.

In Russia, dupilumab is currently approved as a treatment for atopic dermatitis (in children over 6 years of age), asthma (in children over 12 years of age) and severe CRSwNP in adults. This article summarizes the main data on dupilumab and its efficacy in patients with asthma and CRSwNP and presents a relevant case report.

Воспаление дыхательных путей играет ключевую роль при бронхиальной астме (БА) и полипозном риносинусите (ПРС). При этом воспалительный процесс может варьировать по интенсивности, что отражается на клинической картине заболевания и, что самое важное, на эффективности терапии. На сегодняшний день сохраняются высокий темп роста заболеваемости БА и ПРС, неудовлетворённость эффективностью существующей терапии тяжёлых форм БА, а особенно в сочетании с ПРС, поэтому главной задачей является поиск новых подходов для диагностики и терапии. Разработка биопрепаратов, нацеленных на отдельные и специфические компоненты воспаления, является многообещающим шагом вперёд в достижении контроля тяжёлой и плохо контролируемой БА и рецидивирующего ПРС. Одним из последних моноклональных антител, который показал значительные успехи в терапии БА и ПРС, является дупилумаб. Дупилумаб ― это полностью человеческое моноклональное антитело, направленное против α-субъединицы рецептора интерлейкина 4 (ИЛ-4Rα), общей как для рецепторных комплексов ИЛ-4, так и для рецепторов ИЛ-4/ИЛ-13. Тем самым это способствует подавлению сигнализации цитокинов 2-го типа (ИЛ-4 и ИЛ-13), так как сигнальный путь ИЛ-4/ИЛ-13/STAT6 играет решающую роль при T2-опосредованном воспалении. В настоящее время дупилумаб одобрен для лечения тяжёлой БА и ПРС, поэтому в данной статье обобщены основные сведения о дупилумабе и его эффективности при данных заболеваниях; представлены также результаты клинического наблюдения.

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