Table 1 Potential therapies for rhinovirus-induced airway remodeling
From: Rhinovirus induces airway remodeling: what are the physiological consequences?
Drug class | Therapeutic | Mechanism of action | Effect on airway remodeling signatures |
|---|---|---|---|
Inhaled corticosteroid (ICS) | Dexamethasone | Glucocorticoid receptor agonist | Blockade of RV-induced MMP-9 production by ALI-differentiated AECs in vitro [62]; no clinical trial data to date |
Fluticasone proprionate | Glucocorticoid receptor agonist | Reduction of RV-induced goblet cell hyperplasia and mucin production in vitro [167]; reduction of RV-induced VEGF in BEAS-2B cells when used alone and reduction of FGF2 when in combination with salmeterol [169]; no clinical trial data to date | |
Budesonide | Glucocorticoid receptor agonist | Suppression of RV-induced CXCL8, IP-10, and VEGF production by AECs in vitro [168]; reduction of MMP-8 production in mild-to-moderate asthmatic children [191]; attenuation of allergen-induced myofibroblast proliferation and reduction of AHR in mild asthmatic adults when used in combination with formoterol [192] | |
Anti-muscarinic | Tiotropium bromide | Long-acting muscarinic receptor antagonist | Modest reduction of RV-induced goblet cell hyperplasia and mucin production in vitro [167]; no clinical trial data to date |
Long-acting beta agonist | Formoterol | β2 adrenergic receptor agonist | Reduction of MMP9 expression in BEAS-2B cells [62]; no clinical trial data of formoterol monotherapy to date |
Antiviral | Pirodavir | Inhibits viral capsid uptake and RNA uncoating | Modest reduction of RV symptoms in healthy subjects [176]; effect on RV-induced airway remodeling not studied |
Pleconaril | Inhibits viral capsid cellular attachment and RNA uncoating | Reduction in length and severity of RV symptoms in healthy subjects [177]; effect on RV-induced airway remodeling not studied | |
Tremacamra | Viral entry inhibitor | Reduction of RV symptom severity in healthy subjects [178]; effect on RV-induced airway remodeling not studied | |
Vapendavir | Inhibits viral capsid uptake and RNA uncoating | Reduction in length and severity of RV symptoms in asthmatic subjects [179]; effect on RV-induced airway remodeling not studied | |
Biologic | Omalizumab | Anti-IgE monoclonal antibody | Reduction in length and severity of RV symptoms, reduced viral shedding, reduced frequency of RV infection, and reduced occurrence of acute exacerbation in children with allergic asthma [181, 193]; decreased MMP concentration in bronchoalveolar lavage fluid, reduced acute exacerbation frequency, decrease in reticular basement membrane thickness in adult subjects with severe asthma [182,183,184] |
Astegolimab | Anti-IL-33 monoclonal antibody | Reduced acute exacerbations in adults with severe asthma [185]; effect on airway remodeling not studied | |
Itepekimab | Anti-IL-33 monoclonal antibody | Reduced acute exacerbations and improved asthma-related quality of life in adults with moderate-to-severe asthma [186]; effect on airway remodeling not studied |