Immune Modulation in Asthma: Current Concepts and Future Strategies

Lommatzsch, Marek

doi:10.1159/000506651

Cited by 16 publications

(14 citation statements)

References 104 publications

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“…It was found that EPA was associated with airway and systemic eosinophils despite treatment with glucocorticoids, which has potential implications for targeting eosinophils in those patients. Accordingly, monoclonal antibodies [48] targeting the essential cytokines for the development, recruitment, and survival of eosinophils, such as anti-IL-5 or anti-IL-5 receptor antibodies, would be a promising strategy in EPA. Atopy did not appear to be a prominent trait in EPA.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment

Feng

Zhang

et al. 2020

Respiration

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Background: Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking. Objective: To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population. Methods: We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma (n = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (≥3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations. Results: Of 546 participants, 61.9% had no exacerbations (n = 338), 29.6% had few exacerbations (n = 162), and 8.4% were exacerbation prone (n = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all p < 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21], respectively), FEV1 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27]), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89]), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13]) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25]) were at high risk of asthma symptom triggers. Conclusion: EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment

Feng

Zhang

et al. 2020

Respiration

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“…Of note, anti-IgE treatment enhances antiviral immunity via a downregulation of the high-affinity IgE receptor (FcεRI) on plasmacytoid dendritic cells (pDCs) [ 7 ], resulting in a reduction of viral exacerbations in asthma [ 8 , 9 ]. The strong correlation of the FcεRI expression on pDCs with total IgE in serum [ 6 ] supported the idea that total IgE in serum plays a genuine role in asthma, independent from allergen-specific IgE [ 10 ].…”

Section: Introductionmentioning

confidence: 91%

IgE is associated with exacerbations and lung function decline in COPD

et al. 2022

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Background Both allergen-specific IgE and total IgE in serum play a major role in asthma. However, the role of IgE in chronic obstructive pulmonary disease (COPD) is poorly understood. It was the aim of this study to systematically analyze the relationship between serum IgE levels and disease characteristics in large COPD cohorts. Methods COSYCONET is a comprehensively characterized cohort of patients with COPD: total IgE and IgE specific to common aeroallergens were measured in serum of 2280 patients, and related to clinical characteristics of the patients. WISDOM is another large COPD population (2477 patients): this database contains the information whether total IgE in serum was elevated (≥ 100 IU/l) or normal in patients with COPD. Results Both in COSYCONET and WISDOM, total IgE was elevated (≥ 100 IU/l) in > 30% of the patients, higher in men than in women, and higher in currently than in not currently smoking men. In COSYCONET, total IgE was elevated in patients with a history of asthma and/or allergies. Men with at least one exacerbation in the last 12 months (50.6% of all men in COSYCONET) had higher median total IgE (71.3 IU/l) than men without exacerbations (48.3 IU/l): this difference was also observed in the subgroups of not currently smoking men and of men without a history of asthma. Surprisingly, a history of exacerbations did not impact on total IgE in women with COPD. Patients in the highest tertiles of total IgE (> 91.5 IU/ml, adjusted OR: 1.62, 95% CI 1.12–2.34) or allergen-specific IgE (> 0.19 IU/ml, adjusted OR: 2.15, 95% CI 1.32–3.51) were at risk of lung function decline (adjusted by: age, gender, body mass index, initial lung function, smoking status, history of asthma, history of allergy). Conclusion These data suggest that IgE may play a role in specific COPD subgroups. Clinical trials using antibodies targeting the IgE pathway (such as omalizumab), especially in men with recurrent exacerbations and elevated serum IgE, could elucidate potential therapeutic implications of our observations.

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“…1,2 This blood eosinophil increase is probably caused by an inhibition of the endothelial expression of VCAM-1 and ICAM-1 which is essential for eosinophil extravasation and dependent on IL-4 receptor alpha. 3 We report cases of dupilumab-induced hypereosinophilia with severe adverse effects occurring within the first 6 weeks after treatment initiation. Case 1: A 49-year-old man (15 pack years until 2017) with severe intrinsic, adult-onset asthma and CRSwNP (not previously treated with biologics) suffered from recurrent asthma exacerbations requiring prednisolone bursts despite high-dose ICS/LABA/LAMA treatment.…”

Section: Eosinophilic Pleural Effusion and Stroke With Cutaneous Vasculitis: Two Cases Of Dupilumab-induced Hypereosinophiliamentioning

confidence: 98%

Eosinophilic pleural effusion and stroke with cutaneous vasculitis: Two cases of dupilumab‐induced hypereosinophilia

Lommatzsch

Stoll

Winkler

et al. 2021

Allergy

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Immune Modulation in Asthma: Current Concepts and Future Strategies

Cited by 16 publications

References 104 publications

Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment

Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment

IgE is associated with exacerbations and lung function decline in COPD

Eosinophilic pleural effusion and stroke with cutaneous vasculitis: Two cases of dupilumab‐induced hypereosinophilia

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