Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Pulmonary Function Tests
2.2.1. Spirometry
2.2.2. Fractional Exhaled Nitric Oxide (FeNO) Test
2.3. Blood Tests
2.3.1. Complete Blood Count and IgE
2.3.2. Measurement of Blood Levels of Selected Analytes
Enzyme-Linked Immunosorbent Assay (ELISA)
2.4. Skin Prick Testing
2.5. Confirmation of Participation in the Study
2.6. Statistical Analysis
3. Results
3.1. Study Subject Characteristics
3.2. Severe Asthma Clinical Remissions Criteria at 24 Weeks of Mepolizumab Treatment
3.3. Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ACT | asthma control test |
CD8+ | cluster of differentiation 8 |
ELISA | enzyme-linked immunosorbent assay |
FeNO | fractional exhaled nitric oxide |
FEV1 | forced expiratory volume in 1 s |
GINA | Global Initiative for Asthma |
Ig | immunoglobulin |
IL | interleukin |
ILC2 | type 2 innate lymphoid |
sFcεRI | soluble high-affinity immunoglobulin E receptor |
sIL-5Rα | soluble IL-5 receptor subunit alpha |
Tfh | T follicular helper |
Th | T-helper |
TSLP | thymic stromal lymphopoietin |
V1 | visit before starting mepolizumab treatment |
V2 | visit 4 weeks after starting mepolizumab treatment (after 1 mepolizumab dose) |
V3 | visit 12 weeks after starting mepolizumab treatment (after 3 mepolizumab doses) |
V4 | visit 24 weeks after starting mepolizumab treatment (after 6 mepolizumab doses) |
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Inclusion Criteria | Exclusion Criteria |
---|---|
Severe asthma history ≥ 12 months High doses of inhaled steroids + long-acting beta agonist + episodic use of oral steroids ≥ 12 months Uncontrolled asthma ≥ 12 months Two or more asthma exacerbations per year, which require short-term systemic corticosteroids (≤14 days). Peripheral blood eosinophil ≥ 0.15 × 109/L | Age < 18 years Asthma exacerbation ≤ 1 months prior to study Supported asthma therapy of oral corticosteroid (>30 days) Active airway infection ≤ 1 months prior to study Active smoking (at least one cigarette a day), former smoker (at least 100 cigarettes in lifetime) Clinically significant non-controlled other organs disease |
Characteristic | T2-High Severe Asthma | |||
---|---|---|---|---|
Number, n | 18 | |||
Sex, M/F | 4/14 | |||
Age, years | 57.6 ± 2.2 | |||
BMI, kg/m2 | 30.3 ± 1.7 | |||
Number of patients with positive skin prick test/negative skin prick test | 8/10 | |||
V1 | V2 | V3 | V4 | |
Number of patients who had asthma exacerbations | 18 | 0 | 1 | 0 |
ACT, score | 10.6 ± 0.8 *#£ | 16.3 ± 1.3 | 17.7 ± 1.2 | 17.1 ± 1.2 |
FEV1, L | 1.84 ± 0.18 *#£ | 2.11 ± 0.16 | 2.15 ± 0.17 | 2.16 ± 0.15 |
FEV1, % of predicted | 66.0 ± 4.9 *#£ | 76.9 ± 4.9 | 77.3 ± 4.4 | 77.6 ± 3.8 |
FeNO, ppb | 48.6 ± 9.7 | 39.3 ± 6.0 | 45.3 ± 9.8 | 41.9 ± 7.1 |
Blood eosinophil level, ×109/L | 0.64 ± 0.08 *#£ | 0.11 ± 0.02 | 0.07 ± 0.01 | 0.07 ± 0.01 |
Total IgE, IU/mL | 128.1 ± 27.9 | 126.7 ± 28.0 | 131.9 ± 27.3 | 127.0 ± 25.7 |
T2-High Severe Asthma | ||||
---|---|---|---|---|
V1 | V2 | V3 | V4 | |
IL-4 (pg/mL) | 30.7 ± 6.5 | 26.3 ± 2.2 | 26.0 ± 4.7 | 24.2 ± 4.2 |
IL-5 (pg/mL) | 111.7 ± 4.4 *#£ | 97.5 ± 4.3 | 83.5 ± 3.0 | 82.8 ± 4.1 |
IL-13 (pg/mL) | 7.2 ± 1.1 *#£ | 5.7 ± 0.9 | 5.5 ± 1.0 | 4.9 ± 0.8 |
IL-25 (ng/mL) | 4.0 ± 0.7 | 3.3 ± 0.5 | 3.5 ± 0.6 | 4.0 ± 0.9 |
IL-33 (pg/mL) | 18. 1 ± 1.0 *#£ | 18.4 ± 1.0 | 19.4 ± 1.0 | 21.3 ± 0.8 |
TSLP (pg/mL) | 49.1 ± 11.9 *#£ | 42.4 ± 10.3 | 39.7 ± 10.0 | 41.8 ± 10.5 |
sIL-5Rα (ng/mL) | 2.84 ± 0.55 *#£ | 2.11 ± 0.47 | 2.43 ± 0.52 | 2.42 ± 0.47 |
Eotaxin (pg/mL) | 143.9 ± 18.2 *#£ | 195.3 ± 25.5 | 201.7 ± 25.9 | 197.5 ± 24.8 |
sFcεRI (ng/mL) | 7.0 ± 1.3 *#£ | 5.9 ± 1.1 | 5.2 ± 0.9 | 4.2 ± 0.6 |
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Palacionyte, J.; Januskevicius, A.; Vasyle, E.; Rimkunas, A.; Miliauskas, S.; Malakauskas, K. Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma. Diagnostics 2024, 14, 1345. https://doi.org/10.3390/diagnostics14131345
Palacionyte J, Januskevicius A, Vasyle E, Rimkunas A, Miliauskas S, Malakauskas K. Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma. Diagnostics. 2024; 14(13):1345. https://doi.org/10.3390/diagnostics14131345
Chicago/Turabian StylePalacionyte, Jolita, Andrius Januskevicius, Egle Vasyle, Airidas Rimkunas, Skaidrius Miliauskas, and Kestutis Malakauskas. 2024. "Clinical Remission Criteria and Serum Levels of Type 2 Inflammation Mediators during 24 Weeks of Treatment with the Anti-IL-5 Drug Mepolizumab in Patients with T2-High Severe Asthma" Diagnostics 14, no. 13: 1345. https://doi.org/10.3390/diagnostics14131345