Why Asthma Keeps Coming Back -Even with Powerful Biologic Drugs
Summary: Biological drugs like mepolizumab and dupilumab have transformed severe asthma care, offering symptom relief and better breathing. But a new study from Karolinska Institutet reveals that these drugs may not fully target the root cause, persistent immune cells that continue to drive inflammation. This might explain why asthma often returns once treatment is stopped.
Are we truly treating asthma, or just managing the symptoms?
Biologics are powerful, targeted drugs that have changed the lives of people with severe asthma by helping them breathe easier and reducing hospital visits. Yet, a surprising discovery by researchers at Karolinska Institutet in Sweden suggests that these therapies may not be the cure we hoped for.
A study published in the journal Allergy reveals that while biologics like mepolizumab and dupilumab reduce asthma symptoms, they may not fully eliminate inflammation-driving immune cells, which may continue to fuel the disease behind the scenes
What Are Biologics and Why Are They Important?
Biologics are lab-made drugs that target specific components of the immune system. They’ve been especially helpful for patients whose asthma doesn’t respond well to standard treatments like inhaled steroids.
“They help most patients to keep their symptoms under control, but exactly how these drugs affect the immune system has so far remained unknown,”
— Dr. Valentyna Yasinska, Karolinska Institutet
Findings of the Study
Researchers examined blood samples from 40 severe asthma patients, both before and during biologic treatment, using advanced techniques like
- Flow cytometry
- Single-cell sequencing
Instead of finding a reduction in inflammation, they saw that some immune cells with high inflammatory potential increased during treatment.
“We were surprised to find that blood levels of inflammatory cells increased rather than decreased,”
— Lorenz Wirth, Karolinska Institutet
Why Does Asthma Come Back?
These findings suggest a critical insight:
- Biologic drugs may only suppress the symptoms, not eliminate the cause.
- The persistent presence or even rise in certain immune cells means that the moment treatment is reduced or stopped, inflammation and symptoms can return.
“This suggests that biologics might not attack the root of the problem, no matter how much they help asthma patients during treatment,”
— Prof. Jenny Mjösberg, Karolinska Institutet
What’s Next in Asthma Research?
The study was part of the BIOCROSS study, and while it brings up new concerns, it also paves the way for further research.
Scientists now plan to examine patients who’ve been on biologics for longer durations and also study lung tissue samples to better understand how immune cells behave inside the airways, not just in the bloodstream
Why This is Important for Long-Term Asthma Management
Although biologics have only been in use for less than a decade, their long-term effects remain unclear. This research emphasizes the need to:
- Understand the underlying immune response.
- Evaluate whether continuous biologic therapy is necessary.
- Explore new drugs or combinations that target inflammation more completely.
Conclusion: Managing Symptoms Isn’t Enough
Biologic drugs like mepolizumab and dupilumab have revolutionised severe asthma care, but they might not fully address the root immune dysfunction driving the disease. They offer much-needed relief, stopping treatment may lead to a return of inflammation, making it crucial to understand the long-term effects and limitations of biologic therapies.
Dane
I am an MBBS graduate and a dedicated medical writer with a strong passion for deep research and psychology. I enjoy breaking down complex medical topics into engaging, easy-to-understand content, aiming to educate and inspire readers by exploring the fascinating connection between health, science, and the human mind.
