Indolfi Cristiana, Dinardo Giulio, Klain Angela, Decimo Fabio, Miraglia Del Giudice Michele
Department of Woman, Child and of General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Naples, Italy.
Life (Basel). 2024 Aug 25;14(9):1063. doi: 10.3390/life14091063.
Asthma is one of the most common chronic inflammatory diseases of childhood with a heterogeneous impact on health and quality of life. Mepolizumab is an antagonist of interleukin-5, indicated as an adjunct therapy for severe refractory eosinophilic asthma in adolescents and children aged >6 years old. We present the case of a 9 year-old boy with severe asthma who experienced several asthmatic exacerbations following a SARS-CoV-2 infection, necessitating therapy with short-acting bronchodilators, oral corticosteroids, and hospitalization. We follow the patient using validated questionnaires for the evaluation of asthma control: Children Asthma Control Test, Asthma Control Questionnaire, respiratory function tests, and evaluation of exhaled nitric oxide fraction. After 12 weeks from the start of therapy with mepolizumab, we found significant improvements in lung function, a reduction in the degree of bronchial inflammation, and improvements in quality of life. No asthmatic exacerbations have been reported since the initiation of treatment with mepolizumab. Respiratory infections, such as those related to SARS-CoV-2, represent a significant risk factor for exacerbations in patients with moderate to severe forms of asthma. In our experience, following new episodes of exacerbation, the initiation of treatment with mepolizumab has allowed us to improve asthma control and enhance the quality of life of patients from the first doses. Although mepolizumab showed promise in this child with severe asthma during SARS-CoV-2 infection, the results from this single case cannot be generalized. Further studies are needed to confirm its safety and effectiveness.
哮喘是儿童期最常见的慢性炎症性疾病之一，对健康和生活质量有不同程度的影响。美泊利珠单抗是一种白细胞介素-5拮抗剂，被用作6岁以上青少年和儿童严重难治性嗜酸性粒细胞性哮喘的辅助治疗药物。我们报告了一例9岁重度哮喘男孩的病例，该男孩在感染SARS-CoV-2后经历了多次哮喘发作，需要使用短效支气管扩张剂、口服糖皮质激素治疗并住院。我们使用经过验证的问卷对该患者进行随访，以评估哮喘控制情况：儿童哮喘控制测试、哮喘控制问卷、呼吸功能测试以及呼出一氧化氮分数评估。在开始使用美泊利珠单抗治疗12周后，我们发现其肺功能有显著改善，支气管炎症程度减轻，生活质量提高。自开始使用美泊利珠单抗治疗以来，未报告有哮喘发作。呼吸道感染，如与SARS-CoV-2相关的感染，是中重度哮喘患者病情加重的重要危险因素。根据我们的经验，在新的加重发作后，开始使用美泊利珠单抗治疗使我们能够从第一剂开始就改善哮喘控制并提高患者的生活质量。尽管美泊利珠单抗在这名感染SARS-CoV-2的重度哮喘儿童中显示出前景，但这一单个病例的结果不能推广。需要进一步研究以证实其安全性和有效性。
