The effect of anti-IL5 monoclonal antibodies on regulatory and effector T cells in severe eosinophilic asthma - 13/09/23
, Tommaso Pianigiani ⁎, 1, Miriana d’Alessandro, Sara Gangi, Behar Cekorja, Elena Bargagli, Paolo CameliAbstract |
Introduction |
Biological treatments have redesigned the clinical management of severe eosinophilic asthmatic (SA) patients. Despite emerging evidence supporting the role of natural Killer (NK), and T regulatory cells (Treg) in the pathogenesis of asthma, no data is available on the effects of anti-IL5/IL5R therapies on these cell subsets.
Methods |
We prospectively enrolled fourteen SA patients treated with benralizumab (n = 7) or mepolizumab (n = 7) and compared them with healthy controls (HC) (n = 11) and mild to moderate asthmatic (MM) patients (n = 9). Clinical parameters were collected at baseline (T0) and during follow-up. Cellular analysis, including the analysis of T/NK cell subsets, was determined through multicolor flow cytometry.
Results |
At T0, SA patients showed higher percentages of CD4 TEM (33.3 ± 17.9 HC, 42.6 ± 16.6 MM and 66.1 ± 19.7 in SA; p < 0.0001) than HC and MM patients. With different timing, the two drugs induce a reduction of CD4 TEM ( 76 ± 19 T0; 43 ± 14 T1; 45 ± 23 T6; 62 ± 18 at T24; p < 0.0001 for mepolizumab and 55 ± 21 T0; 55 ± 22 T1; 43 ± 14 T6; 27 ± 12 at T24; p < 0.0001 for benralizumab) and an increase of Treg cells (1.2 ± 1.3 T0; 5.1 ± 2.5 T1; 6.3 ± 3.4 T6; 8.4 ± 4.6 at T24; p < 0.0001 for mepolizumab and 3.4 ± 1.7 T0; 1.9 ± 0.8 T1; 1.9 ± 1 T6; 5.1 ± 2.4 at T24; p < 0.0001 for benralizumab). The change of CD56dim PD-1+ significantly correlated with FEV1% (r = − 0.32; p < 0.01), while Treg expressing PD-1 correlates with the use of oral steroids ( r = 0.36 p = 0.0008) and ACT score (r = 0.36 p = 0.0008) p < 0.001)
Conclusions |
Beyond the clinical improvement, anti-IL-5 treatment induces a rebalancing of Treg and T effector cells in patients with SA
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Mepolizumab and benralizumab reduces airway inflammation in severe asthmatic patients. |
• | The percentages of regulatory T cells resulted increased after both treatments. |
• | A reduction of regulatory T cells was observed after anti IL-5 MoAbs administration. |
• | Reduction of T effector cells emerged after 24 months of both treatments. |
Abbreviations : SA, IL, NK, Treg, HC, MM, ICs, PD-1, TIGIT, LAG-3, CTLA4, TCM, TEM, TEMRA
Keywords : Benralizumab, Mepolizumab, Severe asthma, Regulatory T cells, Immune checkpoints
Plan
Vol 166
Article 115385- octobre 2023 Retour au numéro
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