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Erschienen in: Current Allergy and Asthma Reports 11/2022

14.09.2022 | Immunotherapy and Immunomodulators (B Vickery, Section Editor)

The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion

verfasst von: Megan E. Milne, Jack Kimball, Teresa K. Tarrant, Rami N. Al-Rohil, David L. Leverenz

Erschienen in: Current Allergy and Asthma Reports | Ausgabe 11/2022

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Abstract

Purposeof Review

The pathogenesis of eosinophilic granulomatosis with polyangiitis (eGPA) is driven largely by CD4 + type 2 helper T cells (Th2), B cells, and eosinophils. Interleukin (IL)-4 and IL-13 are critical cytokines in Th2 cell–mediated inflammation; however, inhibition of IL-4 and IL-13 does not reduce serum eosinophil counts and has even been associated with hypereosinophilia. This review explores the role of IL-4, IL-5, and IL-13 in Th2-mediated inflammation to consider the potential clinical consequences of inhibiting these individual cytokines in eGPA.

Recent Findings

Treatments for eosinophilic granulomatosis with polyangiitis (eGPA) are rapidly evolving through using biologic therapies to modulate the Th2 inflammatory response via eosinophil inhibition. While IL-4, IL-5, IL-13, and IL-25 can all affect eosinophils, only IL-5 inhibition has demonstrated therapeutic benefit to-date. In this review, we report a clinical vignette of a patient with adult-onset asthma who developed severe manifestations of eGPA after switching from mepolizumab (an IL-5 inhibitor) to dupilumab (an inhibitor of IL-4 and IL-13).

Summary

By understanding the role of IL-4, IL-5, and IL-13 in Th2-mediated vasculitis, we can start to understand how eGPA might respond differently to focused cytokine inhibition.
Literatur
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Metadaten
Titel
The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion
verfasst von
Megan E. Milne
Jack Kimball
Teresa K. Tarrant
Rami N. Al-Rohil
David L. Leverenz
Publikationsdatum
14.09.2022
Verlag
Springer US
Erschienen in
Current Allergy and Asthma Reports / Ausgabe 11/2022
Print ISSN: 1529-7322
Elektronische ISSN: 1534-6315
DOI
https://doi.org/10.1007/s11882-022-01039-w

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