Anti-IgE Significantly Changes Circulating Interleukin-25, Vitamin-D and Interleukin-33 Levels in Patients with Allergic Asthma

Abstract

Background: Multi-center, randomized-controlled trials and observational studies have demonstrated that, in severe asthmatic patients receiving omalizumab treatment, the frequency of exacerbations, the number of urgent adverse events, and the need for oral steroids tend to decrease. Material and Method: This study included a total of 32 patients. The patients were divided into two groups as Group IA (pre-omalizumab) and Group IB (post-omalizumab). Serum IL-25 and IL-33 levels were measured and the number of emergency admissions, length of hospitalization (day), Asthma Control Test (ACT) scores, eosinophil cationic protein (ECP), and fractional exhaled nitric oxide (FeNO) value were analyzed. Results: ACT and FeNO values increased after omalizumab treatment, while IL-33, IL-25 levels decreased after the completion of omalizumab treatment. Furthermore, there was a weak, positive, and significant relationship between the changes in the ECP levels and IL-33 levels (r=0.38, p=0.03). Conclusion: To the best of our knowledge, this is the first study to compare circulating IL-25 and IL-33 levels with specific IgE synthesis in the literature. Multivariate correlation analysis showed that the changes in serum IL-33 levels were significantly correlated with the changes in the mite sIgE levels and length of hospital stay (Fmodel=11.2, p=0.01, r2=0.45). On the other hand, there was no significant relationship between the other variables and changes in the IL-25 levels.

COVID-19 and Asthma: Reflection During the Pandemic

“…Another study has also shown the effect of omalizumab on increasing pDC IFN-α responses but reducing the expression of pDC FcεRIα in children with asthma [73]. In addition, IL-33 levels decrease after omalizumab treatment [74,75], which induces the production of pro-inflammatory cytokines (including IL-6, IL-1β, TNF-α, MCP-1, and prostaglandin D2) [76]. Taken together, these observations suggest a potential effect of omalizumab on antiviral responses.…”

Vitamin D status and asthma, lung function, and hospitalization among British adults

“…But recently, randomized controlled clinical trials of children and adults showed that vitamin D supplementation did not have significant effect on alleviating asthma exacerbation ( 39 , 40 ). A study with a relatively small sample size of asthmatic patients found that omalizumab treatment could induce a significant increase in the 25(OH)D levels and Asthma Control Test (ACT) scores compared to pre-treatment levels ( 41 ), which may indicate the association between vitamin D and asthma control. Our observational study found that the serum vitamin D had a negative relationship with current wheeze but was not associated with asthma hospitalization, which may suggest that the serum vitamin D level was possible to influence the control of asthma.…”

Implications of preexisting asthma on COVID-19 pathogenesis

“…Since the crosslinking of IgE with its high affinity receptor, FcεRI, impairs the antiviral response in patients with asthma ( 31 ), it is logical to think that blocking IgE using omalizumab in patients with asthma could reduce susceptibility to COVID-19 infection by boosting IFN signaling, as seen in the case of RV infections ( 86 , 103 ). Furthermore, in patients with allergic asthma, omalizumab treatment also decreased circulating IL-33 levels ( 89 ), that is known to induce the release of proinflammatory mediators (IL-6, IL-1β, TNF-α, MCP-1, and prostaglandin D2) by mast cells ( 88 ). Omalizumab has shown clinical efficacy in decreasing susceptibility of patients with asthma to viral infections such as RV by reducing viral disease duration, viral shedding, and viral disease risk ( 86 ), as well as reducing lower respiratory tract symptoms and improving lung function ( 90 ).…”