Are emerging PGD2 antagonists a promising therapy class for treating asthma?
Until very recently, the management of asthma has centered around a handful of bronchodilators and corticosteroids developed empirically decades ago. The lack of therapeutic innovation is all the more surprising given the pressing clinical need: over 3000 people die of asthma a year in the United States alone, and ~50% of patients report exacerbations necessitating increased treatment in the last year.
That is all set to change. Respiratory medicine is entering a new era of biological therapies—treatments that selectively target specific inflammatory mediators and cellular pathways critical in disease pathophysiology. These treatments have already revolutionized patient care in rheumatology, gastroenterology, dermatology, and oncology. Almost all current and emerging biologic treatments for asthma target ‘type 2’ inflammation and require subcutaneous or intravenous administration. However, several pharmaceutical companies have recently developed inhibitors of prostaglandin D2 (PGD2) signaling offering an oral alternative capable of suppressing the type 2 inflammatory cascade. This editorial focuses on the rationale and efficacy of blocking PGD2 signaling in asthma.