Blood eosinophilia in patients with severe bronchial asthma and chronic polypous rhinosinusitis treated with dupilumab: A review
- Authors: Petukhova A.Y.1, Gromov A.S.1, Solovyov R.V.1, Filippova S.G.1, Prokopieva E.R.1
-
Affiliations:
- Central City Clinical Hospital No. 6
- Issue: Vol 96, No 3 (2024)
- Pages: 303-308
- Section: Reviews
- URL: https://journals.rcsi.science/0040-3660/article/view/255139
- DOI: https://doi.org/10.26442/00403660.2024.03.202650
- ID: 255139
Cite item
Full Text
Abstract
Bronchial asthma and chronic polypous rhinosinusitis are diseases associated with a T2-inflammatory immune response. These nosologies can be combined, creating the preconditions for a more severe course of multimorbidity, requiring the use of genetic engineering biological therapy. Dupilumab is a monoclonal antibody that can specifically bind to the alpha subunit of the interleukin-4 receptor and block the action of interleukins 4 and 13, which play a key role in the development of T2 inflammation. Numerous studies have demonstrated the high effectiveness of this medicament. The use of dupilumab in some cases may be accompanied by an increase in eosinophils in the blood. This article presents scientific base and our own experience in treating patients with dupilumab-associated eosinophilia, in addition we describe an algorithm for examining this group of patients for the purpose of timely diagnosis of diseases such as eosinophilic granulomatosis with polyangiitis, eosinophilic pneumonia, etc. It should be noted that in the most cases eosinophilia during targeted therapy with dupilumab is temporary and does not cause clinical manifestations.
Full Text
##article.viewOnOriginalSite##About the authors
Anna Yu. Petukhova
Central City Clinical Hospital No. 6
Author for correspondence.
Email: anna-petuhova@mail.ru
ORCID iD: 0000-0002-5103-2446
канд. мед. наук, врач-пульмонолог, врач – аллерголог-иммунолог, зав. городским амбулаторно-консультативным отд-нием аллергологии и иммунологии
Russian Federation, EkaterinburgAleksey S. Gromov
Central City Clinical Hospital No. 6
Email: anna-petuhova@mail.ru
ORCID iD: 0009-0008-5345-7510
врач – аллерголог-иммунолог городского амбулаторно-консультативного отд-ния аллергологии и иммунологии
Russian Federation, EkaterinburgRobert V. Solovyov
Central City Clinical Hospital No. 6
Email: anna-petuhova@mail.ru
ORCID iD: 0009-0004-5821-4340
канд. мед. наук, глав. врач
Russian Federation, EkaterinburgSvetlana G. Filippova
Central City Clinical Hospital No. 6
Email: anna-petuhova@mail.ru
ORCID iD: 0009-0007-3066-8609
зам. глав. врача по амбулаторно-поликлинической службе
Russian Federation, EkaterinburgElmira R. Prokopieva
Central City Clinical Hospital No. 6
Email: anna-petuhova@mail.ru
ORCID iD: 0009-0005-7139-0725
канд. мед. наук, зам. глав. врача по медицинской части
Russian Federation, EkaterinburgReferences
- Wechsler ME, Klion AD, Paggiaro P, et al. Effect of Dupilumab on Blood Eosinophil Counts in Patients With Asthma, Chronic Rhinosinusitis With Nasal Polyps, Atopic Dermatitis, or Eosinophilic Esophagitis. J Allergy Clin Immunol Pract. 2022;10(10):2695-709. doi: 10.1016/j.jaip.2022.05.019
- Белевский А.С., Ненашева Н.М., Кравченко Н.Ю., и др. Данные Общероссийского регистра пациентов с тяжелой бронхиальной астмой. Терапевтический архив. 2022;94(7):865-71 [Belevskiy AS, Nenasheva NM, Kravchenko NYu, et al. Data from the Russian Severe Asthma Registry (RSAR). Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(7):865-71 (in Russian)]. doi: 10.26442/00403660.2022.07.201713
- Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl. S29):1-464. doi: 10.4193/Rhin20.600
- Ricciardolo FLM, Levra S, Sprio AE, et al. A real-world assessment of asthma with chronic rhinosinusitis. Ann Allergy Asthma Immunol. 2020;125(1):65-71. doi: 10.1016/j.anai.2020.03.004
- Vatrella A, Fabozzi I, Calabrese C, et al. Dupilumab: a novel treatment for asthma. J Asthma Allergy. 2014;7:123-30. doi: 10.2147/JAA.S52387
- Slager RE, Otulana BA, Hawkins GA, et al. IL-4 receptor polymorphisms predict reduction in asthma exacerbations during response to an anti-IL-4 receptor α antagonist. J Allergy Clin Immunol. 2012;130(2):516-22.e4. doi: 10.1016/j.jaci.2012.03.030
- Фомина Д.С., Федосенко С.В., Бобрикова Е.Н., и др. Эффективность дупилумаба в реальной практике лечения тяжелых форм бронхиальной астмы и атопического дерматита. Терапевтический архив. 2023;95(7):568-73 [Fomina DS, Fedosenko SV, Bobrikova EN, et al. Efficacy of dupilumab in real practice in the treatment of severe forms of asthma and atopic dermatitis (comparative retrospective study). Terapevticheskii Arkhiv (Ter. Arkh.). 2023;95(7):568-73. doi: 10.26442/00403660.2023.07.202309 (in Russian)].
- Wechsler ME, Ford LB, Maspero JF, et al. Long-term safety and efficacy of dupilumab in patients with moderate-to-severe asthma (TRAVERSE): an open-label extension study. Lancet Respir Med. 2022;10(1):11-25. doi: 10.1016/S2213-2600(21)00322-2
- Bachert C, Han JK, Desrosiers M, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet. 2019;394(10209):1638-50. doi: 10.1016/S0140-6736(19)31881-1
- Caminati M, Micheletto C, Norelli F, et al. Safety of dupilumab in T2 airways conditions: focus on eosinophilia across trials and real-life evidence. Expert Opin Biol Ther. 2024;24(1-2):15-23. doi: 10.1080/14712598.2024.2304556
- Rabe KF, Nair P, Brusselle G, et al. Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. N Engl J Med. 2018;378(26):2475-85. doi: 10.1056/NEJMoa1804093
- Bachert C, Han JK, Desrosiers M, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet. 2019;394(10209):1638-50. doi: 10.1016/S0140-6736(19)31881-1
- Shinkai A, Yoshisue H, Koike M, et al. A novel human CC chemokine, eotaxin-3, which is expressed in IL-4-stimulated vascular endothelial cells, exhibits potent activity toward eosinophils. J Immunol. 1999;163(3):1602-10
- Yoshifuku K, Matsune S, Ohori J, et al. IL-4 and TNF-alpha increased the secretion of eotaxin from cultured fibroblasts of nasal polyps with eosinophil infiltration. Rhinology. 2007;45(3):235-41.
- Butt NM, Lambert J, Ali S, et al. Guideline for the investigation and management of eosinophilia. Br J Haematol. 2017;176(4):553-72. doi: 10.1111/bjh.14488
- Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Available at: https://ginasthma.org/2023-gina-main-report. Accessed: 02.12.2023.
Supplementary files
![](/img/style/loading.gif)