Lung Transplant Center, Division of Pulmonology, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Lung Transplant Center, Division of Pulmonology, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland; Internal Medicine service, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Clin Immunol. 2024 Jul;264:110265. doi: 10.1016/j.clim.2024.110265. Epub 2024 May 25.
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus spp. ABPA diagnosis may be challenging due to its non-specific presentation. Standard ABPA treatment consists of systemic corticosteroids and antifungal agents. Mepolizumab, a monoclonal antibody against interleukin-5 seems to be a promising treatment for ABPA. Data about ABPA following lung transplantation (LuTx) are scarce. LuTx recipients are at higher risk for adverse effects of ABPA treatment compared to the general population. Here we present a case of a LuTx recipient who was successfully treated with mepolizumab for ABPA following LuTx. Prolonged administration of high dose prednisone was thus avoided. To our knowledge, this is the first case describing mepolizumab administration following LuTx. Mepolizumab seems particularly attractive as a corticosteroid-sparing agent or as an alternative option to antifungal treatments, because of its excellent safety profile and low risk of drug interactions.
变应性支气管肺曲霉病（ABPA）是一种对曲霉菌属的复杂超敏反应。由于其非特异性表现，ABPA 的诊断可能具有挑战性。ABPA 的标准治疗包括全身皮质类固醇和抗真菌药物。白细胞介素-5 的单克隆抗体美泊利珠单抗似乎是 ABPA 的一种有前途的治疗方法。关于肺移植（LuTx）后 ABPA 的数据很少。与普通人群相比，LuTx 受者发生 ABPA 治疗不良反应的风险更高。在这里，我们介绍了一例 LuTx 受者在 LuTx 后成功接受美泊利珠单抗治疗 ABPA 的病例。因此避免了长时间使用大剂量泼尼松龙。据我们所知，这是首例描述 LuTx 后使用美泊利珠单抗的病例。由于其出色的安全性和低药物相互作用风险，美泊利珠单抗作为皮质类固醇节约剂或作为抗真菌治疗的替代选择特别有吸引力。
