Fig. 2
From: Monoclonal antibodies in type 2 asthma: a systematic review and network meta-analysis
Mechanism of action of agents included in the meta-analysis. Mechanisms of action of monoclonal antibodies included in our meta-analysis (a) IL-5 is a critical factor for growth, differentiation and activation of eosinophils. Mepolizumab and reslizumab act as antibodies to IL-5 cytokines, binding to them and preventing their association with the receptor. Benralizumab is an IL-5 receptor blocker. It binds to the alpha chain of the IL-5 receptor (IL-5Rα), expressed on eosinophils. The antibody’s Fc domain binds to the FcγRIIIa domain, expressed on natural killer cells, which induces eosinophils’ apoptosis. b TSLP is an important cytokine in the inflammatory cascade, as it activates dendritic cells, inducing inflammatory reactions through their effects on T cells differentiation. Tezepelumab inhibits TSLP effects by binding to the cytokine. IL-4 is a potent inducer for TH2 cells differentiation, existing on several types of immune cells. Dupilumab binds to the alpha subunit of IL-4 receptor, inhibiting its effects. Lebrikizumab binds to IL-13 cytokines, and tralokinumab binds to its receptor on B cells, inhibiting its effects on IgE production