New directions in allergic diseases: mechanism-based anti-inflammatory therapies.

Advances in our understanding of allergic inflammation have led to the development of several novel anti-inflammatory drugs that target specific aspects of the inflammatory process. These treatments are based on improvements in existing therapies or on a better understanding of the cellular and molecular mechanisms involved in atopic diseases. Although most attention has been focused on asthma, treatments that inhibit the atopic disease process would have application to all atopic diseases, which often coincide. Specific agents that are now in development for the treatment of allergic inflammation include inhibitors of eosinophilic inflammation (eg, anti-IL-5, CCR3 antagonists, and very late antigen 4 inhibitors), drugs that may inhibit allergen presentation, and inhibitors of T(H)2 cells. More general anti-inflammatory approaches include novel cortico-steroids, phosphodiesterase inhibitors, and mitogen-activated protein kinase inhibitors. Most of the new therapies in development are aimed at inhibiting or suppressing components of the allergic inflammatory response, but in the future, there are possibilities for development of preventive and curative treatments.