*Review* **Advances and Challenges of Antibody Therapeutics for Severe Bronchial Asthma**

**Yuko Abe 1,2, Yasuhiko Suga 1, Kiyoharu Fukushima 1,2,3,\*, Hayase Ohata 1, Takayuki Niitsu 1,2, Hiroshi Nabeshima 2,3, Yasuharu Nagahama 2,3, Hiroshi Kida <sup>4</sup> and Atsushi Kumanogoh 1,5,6**


**Abstract:** Asthma is a disease that consists of three main components: airway inflammation, airway hyperresponsiveness, and airway remodeling. Persistent airway inflammation leads to the destruction and degeneration of normal airway tissues, resulting in thickening of the airway wall, decreased reversibility, and increased airway hyperresponsiveness. The progression of irreversible airway narrowing and the associated increase in airway hyperresponsiveness are major factors in severe asthma. This has led to the identification of effective pharmacological targets and the recognition of several biomarkers that enable a more personalized approach to asthma. However, the efficacies of current antibody therapeutics and biomarkers are still unsatisfactory in clinical practice. The establishment of an ideal phenotype classification that will predict the response of antibody treatment is urgently needed. Here, we review recent advancements in antibody therapeutics and novel findings related to the disease process for severe asthma.

**Keywords:** asthma; refractory asthma; antibody therapeutics; biomarker
