The importance of being not significant: Blood eosinophils and clinical responses do not correlate in severe asthma patients treated with mepolizumab in real life

Bagnasco, Diego; Massolo, Alessandro; Bonavia, Marco; Brussino, Luisa; Bucca, Caterina; Caminati, Marco; Canonica, Giorgio Walter; D’Amato, Maria; Ferrari, Laura De; Guida, Giuseppe; Heffler, Enrico; Lombardi, Carlo; Menzella, Francesco; Milanese, Manlio; Paoletti, Giovanni; Riccio, Anna Maria; Rolla, Giovanni; Senna, Gianenrico; Testino, Elisa; Passalacqua, Giovanni

doi:10.1111/all.14135

Cited by 19 publications

(16 citation statements)

References 9 publications

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“…The role of eosinophils in personalized asthma treatment remains controversial. In a real‐life study, Bagnasco et al showed no correlation between peripheral blood eosinophils count with the clinical, functional, and biological outcome changes in asthma patients 136,137 …”

Section: Asthma Diagnosis Precision Medicine and Biomarkersmentioning

confidence: 99%

“…In a real-life study, Bagnasco et al showed no correlation between peripheral blood eosinophils count with the clinical, functional, and biological outcome changes in asthma patients. 136,137 Not only frequencies of eosinophils can serve as a biomarker of asthma severity 124 and response to the treatment. 138…”

Section: A S Thma D Iag Nos Is Precis I On Med I Cine and B I Omentioning

confidence: 99%

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Advances and recent developments in asthma in 2020

Cevhertas

Öğülür

Maurer

et al. 2020

Allergy

126

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In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis, and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis, and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping, and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/ multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers, are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2, and COVID-19.

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Section: Asthma Diagnosis Precision Medicine and Biomarkersmentioning

confidence: 99%

Section: A S Thma D Iag Nos Is Precis I On Med I Cine and B I Omentioning

confidence: 99%

Advances and recent developments in asthma in 2020

Cevhertas

Öğülür

Maurer

et al. 2020

Allergy

126

View full text Add to dashboard Cite

show abstract

“…To date, blood eosinophils levels seem to represent the most indicative biomarker in determining response to anti‐IL5/IL5R mAbs even though there is still a debate of its role in real‐life studies 69 . Higher eosinophils levels, the presence of late‐onset asthma, history of nasal polyposis and frequent exacerbations might further increase the chance of good response 43 .…”

Section: Discussionmentioning

confidence: 99%

Treating severe asthma: Targeting the IL‐5 pathway

Principe

Porsbjerg

Ditlev

et al. 2021

Clin Experimental Allergy

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Severe asthma is a heterogeneous disease with different phenotypes based on clinical, functional or inflammatory parameters. In particular, the eosinophilic phenotype is associated with type 2 inflammation and increased levels of interleukin (IL)‐4, IL‐5 and IL‐13). Monoclonal antibodies that target the eosinophilic inflammatory pathways (IL‐5R and IL‐5), namely mepolizumab, reslizumab, and benralizumab, are effective and safe for severe eosinophilic asthma. Eosinophils threshold represents the most indicative biomarker for response to treatment with all three monoclonal antibodies. Improvement in asthma symptoms scores, lung function, the number of exacerbations, history of late‐onset asthma, chronic rhinosinusitis with nasal polyposis, low oral corticosteroids use and low body mass index represent predictive clinical markers of response. Novel Omics studies are emerging with proteomics data and exhaled breath analyses. These may prove useful as biomarkers of response and non‐response biologics. Moreover, future biomarker studies need to be undertaken in paediatric patients affected by severe asthma. The choice of appropriate biologic therapy for severe asthma remains challenging. The importance of finding biomarkers that can predict response continuous an open issue that needs to be further explored. This review describes the clinical effects of targeting the IL‐5 pathway in severe asthma in adult and paediatric patients, focusing on predictors of response and non‐response.

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“…In a real-life study Bagnasco et al showed no correlation between peripheral blood eosinophils count with the clinical, functional, biological outcome changes in asthma patients. 135,136 Not only frequencies of eosinophils can serve as a biomarker of asthma severity 123 and response to the treatment. 137 Rodrigo-Muñoz et al 138 recently reported a set of 14 miRNAs stratifying eosinophils from asthmatic patients and controls.…”

Section: Eosinophils As Biomarkersmentioning

confidence: 99%

Advances and Recent Developments in Asthma in 2020

Cevhertas

Öğülür

Maurer³

et al. 2020

Preprint

View full text Add to dashboard Cite

In this review, we discuss recent publications on asthma and review the studies that have reported on the different aspects of the prevalence, risk factors and prevention, mechanisms, diagnosis and treatment of asthma. Many risk and protective factors and molecular mechanisms are involved in the development of asthma. Emerging concepts and challenges in implementing the exposome paradigm and its application in allergic diseases and asthma are reviewed, including genetic and epigenetic factors, microbial dysbiosis and environmental exposure, particularly to indoor and outdoor substances. The most relevant experimental studies further advancing the understanding of molecular and immune mechanisms with potential new targets for the development of therapeutics are discussed. A reliable diagnosis of asthma, disease endotyping and monitoring its severity are of great importance in the management of asthma. Correct evaluation and management of asthma comorbidity/multimorbidity, including interaction with asthma phenotypes and its value for the precision medicine approach and validation of predictive biomarkers are further detailed. Novel approaches and strategies in asthma treatment linked to mechanisms and endotypes of asthma, particularly biologicals, are critically appraised. Finally, due to the recent pandemics and its impact on patient management, we discuss the challenges, relationships, and molecular mechanisms between asthma, allergies, SARS-CoV-2 and Covid-19.

show abstract

The importance of being not significant: Blood eosinophils and clinical responses do not correlate in severe asthma patients treated with mepolizumab in real life

Cited by 19 publications

References 9 publications

Advances and recent developments in asthma in 2020

Advances and recent developments in asthma in 2020

Treating severe asthma: Targeting the IL‐5 pathway

Advances and Recent Developments in Asthma in 2020

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