2022
DOI: 10.1002/ccr3.5930
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Case of benralizumab‐induced exacerbations of chronic spontaneous urticaria

Abstract: The role of IL-5 in chronic spontaneous urticarial (CSU) is unclear. It may be that benralizumab is an important bidirectional modifier of CSU; that is, blocking IL-5 may improve CSU in some patients, but it is possible that it may worsen CSU in others.

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Cited by 5 publications
(3 citation statements)
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“… 3 , 4 In 1 notable case, a patient started on benralizumab for eosinophilic asthma experienced a flare of his chronic spontaneous urticaria that was previously in remission. 5 The authors of this report theorized that paradoxical IL-5 expression and an increased eosinophil level may have contributed to this patient’s flare; however, this was felt to be unlikely as these levels were normal. A more likely hypothesized mechanism is that benralizumab’s high affinity for the FcγRIIIa receptor of natural killer cells may have led to increased mast cell activation and subsequent pathology.…”
Section: Discussionmentioning
confidence: 85%
“… 3 , 4 In 1 notable case, a patient started on benralizumab for eosinophilic asthma experienced a flare of his chronic spontaneous urticaria that was previously in remission. 5 The authors of this report theorized that paradoxical IL-5 expression and an increased eosinophil level may have contributed to this patient’s flare; however, this was felt to be unlikely as these levels were normal. A more likely hypothesized mechanism is that benralizumab’s high affinity for the FcγRIIIa receptor of natural killer cells may have led to increased mast cell activation and subsequent pathology.…”
Section: Discussionmentioning
confidence: 85%
“…Moreover, since adenosine suppresses the gap formation of vascular endothelial cells and antigen-IgE-related histamine release from peripheral blood basophils and skin mast cells activation via adenosine receptors (A2a and A2b), adenosine and adenosine analogs (including agonist for A2a and A2b) could also be effective for treating CSU. On the other hand, crucial involvements of IL-4 and IL-5 in the pathogenesis of CSU were suggested via the favorable results of clinical trials of the anti-IL-4/13 receptor antibody, dupilumab [ 61 ], anti-IL-5 (mepolizumab, reslizumab) [ 62 , 63 ] and anti-IL-5R (benralizumab) antibody [ 64 ]. Moreover, levels of IL-4 in plasma and numbers of IL-4 expressing cells in the skin of patients with CSU are higher than those of health controls [ 65 , 66 ].…”
Section: Treatment Targeting Basophil-related Molecules In the Pathog...mentioning
confidence: 99%
“…Dear Editor, In the 10th volume, 6th issue of Clinical Case Reports, we read the article of Dr Megan and colleagues entitled "Case of benralizumab-induced exacerbations of chronic spontaneous urticaria." 1 We thank for their valuable case report which they mentioned about benralizumab induced urticaria. In this case report they gave benralizumab treatment to an uncontrolled severe asthma patient who had an history of autologous serum skin test positive chronic spontaneous urticaria (CSU).…”
mentioning
confidence: 93%