期刊
ALLERGOLOGY INTERNATIONAL
卷 69, 期 2, 页码 178-186出版社
JAPANESE SOCIETY ALLERGOLOGY
DOI: 10.1016/j.alit.2020.02.002
关键词
Benralizumab; Chronic rhinosinusitis with nasal polyps; Eosinophils; IL-5; Mepolizumab
资金
- Environmental Restoration and Conservation Agency
- Japan Agency for Medical Research and Development (AMED) [JP19ek0410055, JP17ek0410040, JP16ek0109062]
- Mochida Memorial Foundation for Medical and Pharmaceutical Research
- Japanese Society of Laboratory Medicine Fund for Promotion of Scientific Research
- Japan Society for the Promotion of Science KAKENHI [15KK0329, 16K08926, 17K09993, 17H04344]
- Health Labour Sciences Research Grant [H30Nantitou(nan)-Ippan-016]
IL-5 is the most potent activator of eosinophils and is produced by Th2 cells and ILC2s. A role for IL-5 in eosinophil extracellular trap cell death, i.e., a proinflammatory cell death, has also been reported. Mepolizumab and benralizumab are humanized mAbs that target IL-5 and the IL-5 receptor a, respectively, and their therapeutic efficacy for severe asthma has been established. Although consistent differences in the efficacies of those drugs have not been proven, benralizumab extensively depleted eosinophils via Ab-dependent cell-mediated cytotoxicity. Blood eosinophil count, but not FeNO or IgE, is the best-established predictive biomarker of the efficacy of anti-IL-5 treatment. Regarding the choice of biologics, the balance between blood eosinophil count and FeNO, indication of comorbidities, longitudinal safety, and interval of injection should be considered. Mepolizumab was also effective in maintaining the remission of refractory eosinophilic granulomatous polyangiitis. Moreover, mepolizumab decreased the proportion of patients who required surgery and lowered the nasal polyp score in patients with chronic rhinosinusitis with nasal polyps; a further extensive trial is currently under way. In a phase II benralizumab study performed in Japan, no significant effect on nasal polyp score at week 12 was observed, suggesting a requirement for longer treatment. In this review, the role of IL-5 in eosinophil biology and the current status of anti-IL-5 therapy are discussed. The longitudinal safety of anti-IL-5 therapy has been increasingly established, and this strategy will be continuously indicated for eosinophilic diseases as a specific treatment for eosinophilic inflammation. Copyright (C) 2020, Japanese Society of Allergology. Production and hosting by Elsevier B.V.
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