Moermans Catherine, Decerf Nicolas, Javaux Nicolas, Onssels Adrien, Bricmont Noémie, Bonhiver Romane, Regnier France, Rosu Adeline, Graff Sophie, Gerday Sara, Njock Makon-Sébastien, Paulus Virginie, Guissard Françoise, Ziant Stéphanie, Sanchez Carole, Louis Renaud, Schleich Florence
Giga I3, Pneumology Research Group, Liege University, 4000, Liege, Belgium; Dept. of Pneumology-Allergology, CHU of Liege, 4000, Liege, Belgium.
Haute école de la Province de Liège (HEPL), 4000, Liège, Belgium.
Respir Med. 2025 Jul;243:108151. doi: 10.1016/j.rmed.2025.108151. Epub 2025 May 8.
Benralizumab is an anti-IL-5 receptor (IL-5R) therapy linked to a huge improvement of the condition of patients with severe eosinophilic asthma. The goal of this study was to identify baseline airway markers of remission and response after anti-IL5R therapy.
This observational study included 45 patients initiated with an anti-IL-5R. Remission was defined as: no oral corticosteroids intake, no exacerbation, a good asthma control (ACQ <1.5 and/or ACT >19) and a good lung function (FEV ≥ 80 % predicted and/or an improvement ≥10 %). Components of remission were also assessed individually to evaluate the response of patients. Sputum levels of mediators implicated in inflammation and remodeling were measured before treatment.
Among the 45 patients, 12 were classified in remission. These patients were younger at baseline, had a lower smoking exposure, better asthma control and quality of life and a higher FeNO compared to the others. Moreover, baseline blood eosinophil counts were similar but sputum IL-6 and IL-8 levels were significantly higher in the non-remission group. Finally, patients who only improved their ACT or ACQ score had higher baseline FeNO values or sputum eosinophil percentage respectively. Those who increased their FEV ≥ 10 % presented a higher baseline sputum eosinophil percentage, sputum eotaxin-3 level and a trend for a higher sputum IL-5 level.
High baseline airway T2 markers appeared to be associated with response to anti-IL-5R therapy. Lower sputum IL-6 and IL-8 levels were linked to remission. These results need to be validated in a bigger cohort.
贝那利珠单抗是一种抗白细胞介素-5受体（IL-5R）疗法，与重度嗜酸性粒细胞性哮喘患者病情的显著改善相关。本研究的目的是确定抗IL-5R治疗后缓解和反应的基线气道标志物。
这项观察性研究纳入了45例开始接受抗IL-5R治疗的患者。缓解定义为：未口服皮质类固醇，无病情加重，哮喘控制良好（哮喘控制问卷[ACQ]<1.5和/或哮喘控制测试[ACT]>19）且肺功能良好（第1秒用力呼气容积[FEV]≥预测值的80%和/或改善≥10%）。还分别评估了缓解的各个组成部分，以评估患者的反应。在治疗前测量痰液中与炎症和重塑相关的介质水平。
在45例患者中，12例被归类为缓解。与其他患者相比，这些患者在基线时更年轻，吸烟暴露量更低，哮喘控制和生活质量更好，呼出一氧化氮（FeNO）水平更高。此外，非缓解组的基线血嗜酸性粒细胞计数相似，但痰液白细胞介素-6（IL-6）和白细胞介素-8（IL-8）水平显著更高。最后，仅改善ACT或ACQ评分的患者分别具有更高的基线FeNO值或痰液嗜酸性粒细胞百分比。FEV增加≥10%的患者表现出更高的基线痰液嗜酸性粒细胞百分比、痰液嗜酸性粒细胞趋化因子-3水平以及痰液白细胞介素-5水平升高的趋势。
高基线气道2型标志物似乎与抗IL-5R治疗的反应相关。较低的痰液IL-6和IL-8水平与缓解相关。这些结果需要在更大的队列中进行验证。
