The role of anti-eosinophilic therapies in eosinophilic granulomatosis with polyangiitis: a systematic review

Kouverianos, Ioannis; Angelopoulos, Andreas; Daoussis, Dimitrios

doi:10.1007/s00296-023-05326-1

Cited by 5 publications

(1 citation statement)

References 62 publications

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“…In theory, these drugs should be more effective in ANCAnegative individuals who exhibit a profile with eosinophilic features. However, this hypothesis has not yet been substantiated by clinical data (64,65). Currently, the efficacy and safety of benralizumab are under evaluation, comparing it to mepolizumab in EGPA patients who are receiving standard care therapy (NCT 04157348).…”

Section: Treatmentmentioning

confidence: 99%

Renal involvement in eosinophilic granulomatosis with polyangiitis

Reggiani,

L’Imperio,

Calatroni

et al. 2023

Front. Med.

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Eosinophilic granulomatosis with polyangiitis (EGPA) is a necrotizing vasculitis, which typically affects small-to medium-sized blood vessels. It is characterized by the presence of tissue infiltrates rich in eosinophils, along with the formation of granulomatous lesions. About 40% of cases have positive anti-neutrophil cytoplasm antibodies (ANCA), with predominant perinuclear staining, and anti-myeloperoxidase (anti-MPO) specificity in about 65% of cases. Typical manifestations of EGPA include the late onset of asthma, nasal and sinus-related symptoms, peripheral neuropathy, and significant eosinophilia observed in the peripheral blood. In contrast to granulomatosis with polyangiitis and microscopic polyangiitis, renal involvement in EGPA is less frequent (about 25%) and poorly studied. Necrotizing pauci-immune crescentic glomerulonephritis is the most common renal presentation in patients with ANCA-positive EGPA. Although rarely, other forms of renal involvement may also be observed, such as eosinophilic interstitial nephritis, mesangial glomerulonephritis, membranous nephropathy, or focal sclerosis. A standardized treatment for EGPA with renal involvement has not been defined, however the survival and the renal outcomes are usually better than in the other ANCA-associated vasculitides. Nonetheless, kidney disease is an adverse prognostic factor for EGPA patients. Larger studies are required to better describe the renal involvement, in particular for patterns different from crescentic glomerulonephritis, and to favor the development of a consensual therapeutic approach. In this article, in addition to personal data, we will review recent findings on patient clinical phenotypes based on ANCA, genetics and the impact of biological drugs on disease management.

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Section: Treatmentmentioning

confidence: 99%

Renal involvement in eosinophilic granulomatosis with polyangiitis

Reggiani,

L’Imperio,

Calatroni

et al. 2023

Front. Med.

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Treatment strategies for ANCA-associated vasculitides: from standard protocols to future horizons

Reggiani,

Stella,

Calatroni

et al. 2024

Expert Review of Clinical Immunology

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Interleukin‐5 as a pleiotropic cytokine orchestrating airway type 2 inflammation: Effects on and beyond eosinophils

Buchheit,

Shaw,

Chupp

et al. 2024

Allergy

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Interleukin (IL)‐5 is the key cytokine in the maturation, activation, proliferation, migration and survival of eosinophils, which are key effector cells in many upper and lower airway diseases. Through its effects on eosinophils, IL‐5 indirectly contributes to various pathophysiological processes including tissue damage, repair and remodelling. Understanding the importance of IL‐5 in eosinophil‐associated diseases led to the development of anti‐IL‐5 therapies, which provide clinical benefits across a range of conditions. However, recent evidence suggests that eosinophil‐depletion alone may not account for all of the therapeutic effects of anti‐IL‐5 therapy and that IL‐5 may also contribute to disease independently of its effects on eosinophils. Indeed, evidence from ex vivo studies and targeted therapy in vivo demonstrates that IL‐5 and its inhibition affects a much broader range of cells beyond eosinophils, including epithelial cells, plasma cells, mast cells, basophils, neutrophils, type 2 innate lymphoid cells, T regulatory cells and fibroblasts. This review will provide an update on the evidence supporting the breadth of IL‐5 biology relevant to disease pathogenesis beyond eosinophil‐associated inflammation, where there is a need for additional insight, and the clinical implications of a more central role of IL‐5 in type 2 inflammation.

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The role of anti-eosinophilic therapies in eosinophilic granulomatosis with polyangiitis: a systematic review

Cited by 5 publications

References 62 publications

Renal involvement in eosinophilic granulomatosis with polyangiitis

Renal involvement in eosinophilic granulomatosis with polyangiitis

Treatment strategies for ANCA-associated vasculitides: from standard protocols to future horizons

Interleukin‐5 as a pleiotropic cytokine orchestrating airway type 2 inflammation: Effects on and beyond eosinophils

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