Nov. 24, 1999 (Atlanta) -- Current treatments for asthma and other allergic disorders may be good, but one researcher thinks they can get even better -- and even foresees a day when children might get an overall allergy vaccine that would "cure" asthma.
But, he warns, don't hold your breath. "It is very difficult to find treatments better than the ones we have now because you are competing with inhaled steroids," says Peter Barnes, DM, DSc, of the National Heart & Lung Institute at Imperial College in London. "They are fairly safe to use and fairly cheap. New drugs would have to have some advantage. One advantage could be that they could work by mouth." Inhaled steroids are used to decrease the inflammation in the lungs that contributes to the blocked airways.
The trouble is, developing better treatments would necessitate finding drugs that work differently than the ones now available -- and that might mean tinkering with the body's immune system, something Barnes concedes could be dangerous. "Once you start interfering with fundamental immune mechanisms, this may have long-term adverse consequences in terms of increasing the risk of other diseases," he says.
But as Barnes outlines in the latest issue of Nature, that hasn't stopped such research from going forward. Among the possible treatments: anti-interleukin-5 antibodies, which are now being tested on humans. These compounds interfere with the production of eosinophils -- white blood cells that contribute to the airway tightening seen in asthma. Barnes says the drugs seem to get rid of the eosinophils just fine -- the only problem is they don't seem to do much for the symptoms of asthma.
Another possibility: anti-IgE antibodies. Barnes says people with severe asthma seem to benefit from these compounds, which can defuse not only asthma but more life-threatening allergic reactions as well.
There is a common goal with these compounds. "The thinking is if you could get a drug to work on the basic molecular mechanism of allergy, then you could actually treat asthma, hay fever, and eczema all in the same treatment," Barnes tells WebMD. That's also the idea behind a potential vaccine, which would, in effect, permanently "reset" the body's immune system to keep it from overreacting. But there is a serious drawback to vaccine development, he says: the need to test them in infants.
Barnes says it's one reason why inhalers -- steroid and airway openers -- will remain the mainstay of asthma therapy, at least for now. "But we are talking about inhalers there," he says. "[They] obviously wouldn't apply to treating eczema, rhinitis, and these other (allergic) things." It's one reason why the search for an overall answer to allergic reactions goes on.
- Although the current treatment for asthma, inhaled steroids, is very safe and effective, researchers are searching for even better options, including a vaccine that could treat not only asthma, but hay fever, eczema, and life-threatening allergic reactions.
- Researching new drugs is potentially dangerous because interfering with the immune system can have long-term, adverse consequences.
- Two types of compounds being developed currently are anti-interleukin-5 antibodies and anti-IgE antibodies.