2022
DOI: 10.1007/s11882-022-01039-w
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The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion

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 cl… Show more

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Cited by 10 publications
(10 citation statements)
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“…14 Table 2 summarises six case reports describing EGPA diagnosed after initiation of dupilumab. [15][16][17][18][19][20] In the case presented by Anai et al, dupilumab was first switched to mepolizumab after EGPA onset, and reintroduced later concomitantly with mepolizumab given the insufficient control of asthma, with good results, pointing to the possibility of combination therapy. 19 The pathophysiology of the hypereosinophilia induced by dupilumab can be partially explained by an inhibition of the migration of eosinophils to tissues without inhibition of the eosinophilopoiesis, resulting in accumulation of eosinophils in the blood.…”
Section: Vasculitis Vasculitis Vasculitismentioning
confidence: 99%
“…14 Table 2 summarises six case reports describing EGPA diagnosed after initiation of dupilumab. [15][16][17][18][19][20] In the case presented by Anai et al, dupilumab was first switched to mepolizumab after EGPA onset, and reintroduced later concomitantly with mepolizumab given the insufficient control of asthma, with good results, pointing to the possibility of combination therapy. 19 The pathophysiology of the hypereosinophilia induced by dupilumab can be partially explained by an inhibition of the migration of eosinophils to tissues without inhibition of the eosinophilopoiesis, resulting in accumulation of eosinophils in the blood.…”
Section: Vasculitis Vasculitis Vasculitismentioning
confidence: 99%
“…EGPA was classically considered a type 2 T-helper (Th2)-mediated disease due to cardinal features such as eosinophilic inflammation and “allergic” manifestations. Th2 cytokines (interleukin (IL)-4, IL-5, and IL-13), which have been found elevated in the serum and tissues from EGPA patients, promote eosinophilic activity [3 ▪ ,6]. Among the other, IL-5 is essential for eosinophils maturation, activation, and survival [3 ▪ ].…”
Section: Eosinophilic Granulomatosis With Polyangiitis Pathophysiologymentioning
confidence: 99%
“…Th2 cytokines (interleukin (IL)-4, IL-5, and IL-13), which have been found elevated in the serum and tissues from EGPA patients, promote eosinophilic activity [3 ▪ ,6]. Among the other, IL-5 is essential for eosinophils maturation, activation, and survival [3 ▪ ]. In EGPA, eosinophils appear not only expanded, but also qualitatively impaired, displaying an increased expression of surface markers of activation (i.e.…”
Section: Eosinophilic Granulomatosis With Polyangiitis Pathophysiologymentioning
confidence: 99%
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“…Patients with EGPA can be genetically distinguished into 2 groups; the first group characterized by HLA-DQA1 polymorphisms has positive MPO-ANCAs, whereas the second group has no association with HLA-DQA1 and is MPO-ANCA negative [ 16 , 17 ]. Although EGPA is classified as an ANCA-associated vasculitis, the percentage of patients with ANCA (mostly MPO/p-ANCA) varies among several studies and fluctuates between 30 and 60% [ 7 , 16 , 18 ]. Nevertheless, all patients, regardless of their ANCA status, have eosinophilia and allergic background.…”
Section: Introductionmentioning
confidence: 99%