Table 2. Potential ILC2 targets as novel therapies for chronic lung diseases.
Class of target molecule | Drug | Key results | References |
---|---|---|---|
Molecules that activate ILC2s | |||
IL-25/IL-25R | Anti-IL-25 and anti-IL-25R | Pre-clinical. Inhibition of inflammation and airway hyperresponsiveness in experimental models of lung inflammation | 183–185 |
IL-33/IL-33R (ST2) | Anti-ST2 antibody GSK3772847 RG6149/AMG282) Anti-IL-33 ANB020 |
Antibodies that inhibit IL-33 signaling are in clinical development | 186 |
TSLP/TSLPR | anti-TSLP Tezepelumab |
Administration reduced lung inflammation and airways bronchoconstriction in mild asthma, and lowered rates of asthma exacerbations in patients with uncontrolled asthma | 155, 187 |
IL-9/IL-9R | Anti-IL-9 and anti-IL-9R MEDI-528 |
Humanized IL-9 antagonist that inhibits features of asthma in pre-clinical experimental models. No available data in humans | 188 |
Prostaglandin pathway | CRTH2 antagonists OC000459 (Timapiprant) BI 671800 AZD1981 Fevipiprant |
Compounds have entered clinical trials. Notably, Fevipiprant treatment of patients on inhaled corticosteroids improved Forced Expiratory Volume and reduced sputum eosinophilia | 189–192 |
Anti-huCRTH2 antibody | Pre-clinical humanized anti-huCRTH2 antibody causes depletion of CRTH2-expressing cells | 193 | |
Leukotriene pathway | Montelukast and Zafirlukast are cysteinyl leukotriene receptor antagonists | ILC2 expression of type-2 cytokines is partially inhibited by Montelukast in vitro | 182, 194 |
Arginase | 2(S)-amino-6-boronohexonic acid (ABH) or S-(2-boronoethyl)-L-cysteine (BEC) | Efficacy in pre-clinical experimental asthma models. Arginase inhibitors are in clinical trials as a cancer therapeutics. | 195–198 |
Beta-2 adrenergic receptor | Beta-2 adrenergic receptor agonists | ILC2 express β2AR and inactivating β2AR resulted in lower helminth burden and more ILC2s, eosinophils, and type 2 cytokine production in mice. | 135 |
Transcription factors | |||
GATA3 | Antisense DNAzyme molecule (SB010) that cleaves GATA3 mRNA | Administration of SB010 in a small clinical trial resulted in improved lung function and reduced eosinophilia following allergen provocation | 199–201 |
ILC2-derived cytokines | |||
IL-4 | Anti-IL-4 receptor alpha (IL-4R) antibody Dupilumab |
The anti-IL-4 receptor alpha (IL-4R) antibody (Dupilumab) that inhibits signaling by both IL-4 and IL-13 has proven efficacious in patients with asthma and atopic dermatitis | 202, 203 |
IL-5 | Anti-IL-5 antibody Mepolizumab |
Has proven beneficial in the treatment of people with uncontrolled severe eosinophilic asthma | 204–207 |
IL-13 | Anti-IL-13 antibody Lebrikizumab Tralokinumab |
Limited improvements in lung function in periostin-high and eosinophilic patients, but failed to reduce asthma exacerbations | 208, 209 |