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Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU

INTRODUCTION: About 10% of the 300 million people worldwide who suffer from asthma have a severe disease that is uncontrolled despite treatment with inhaled corticosteroids and long-acting beta agonists. The eosinophilic inflammation pathway in the respiratory tract and blood is involved and interle...

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Autores principales: Barbarot, Nicolas, Nourry, Emmanuelle, Massart, Nicolas, Legay, François, Debarre, Matthieu, Fillatre, Pierre, Magalhaes, Eric, Mari, Arnaud, Wallois, Julien, Briens, Eric, Jouneau, Stéphane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420636/
https://www.ncbi.nlm.nih.gov/pubmed/36046750
http://dx.doi.org/10.1155/2022/2180795
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author Barbarot, Nicolas
Nourry, Emmanuelle
Massart, Nicolas
Legay, François
Debarre, Matthieu
Fillatre, Pierre
Magalhaes, Eric
Mari, Arnaud
Wallois, Julien
Briens, Eric
Jouneau, Stéphane
author_facet Barbarot, Nicolas
Nourry, Emmanuelle
Massart, Nicolas
Legay, François
Debarre, Matthieu
Fillatre, Pierre
Magalhaes, Eric
Mari, Arnaud
Wallois, Julien
Briens, Eric
Jouneau, Stéphane
author_sort Barbarot, Nicolas
collection PubMed
description INTRODUCTION: About 10% of the 300 million people worldwide who suffer from asthma have a severe disease that is uncontrolled despite treatment with inhaled corticosteroids and long-acting beta agonists. The eosinophilic inflammation pathway in the respiratory tract and blood is involved and interleukin-5 (IL-5) has recently been identified as a major promotor of this pathway. The anti-IL-5 antibodies reduce the incidence of exacerbation and allowed steroid sparing in severe asthma patients but only two case reports have been published on their use in critical care. Case Presentation. This report describes the extraordinary clinical improvement of a young patient with steroid-refractory eosinophilic acute severe asthma who required mechanical ventilation, VV-ECMO followed by treatment with mepolizumab. The salient point in this case is the use of an anti-IL-5 monoclonal antibody for a critically ill patient whose condition was deteriorating despite mechanical ventilation and VV-ECMO. The usual steroid treatment failed to control the increase in blood eosinophils or his bronchial inflammation and constriction. CONCLUSION: Anti-IL-5 antibodies are now a standard treatment for severe eosinophilic asthma that can also be useful in an emergency to treat steroid-refractory eosinophilic acute severe asthma.
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spelling pubmed-94206362022-08-30 Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU Barbarot, Nicolas Nourry, Emmanuelle Massart, Nicolas Legay, François Debarre, Matthieu Fillatre, Pierre Magalhaes, Eric Mari, Arnaud Wallois, Julien Briens, Eric Jouneau, Stéphane Case Rep Pulmonol Case Report INTRODUCTION: About 10% of the 300 million people worldwide who suffer from asthma have a severe disease that is uncontrolled despite treatment with inhaled corticosteroids and long-acting beta agonists. The eosinophilic inflammation pathway in the respiratory tract and blood is involved and interleukin-5 (IL-5) has recently been identified as a major promotor of this pathway. The anti-IL-5 antibodies reduce the incidence of exacerbation and allowed steroid sparing in severe asthma patients but only two case reports have been published on their use in critical care. Case Presentation. This report describes the extraordinary clinical improvement of a young patient with steroid-refractory eosinophilic acute severe asthma who required mechanical ventilation, VV-ECMO followed by treatment with mepolizumab. The salient point in this case is the use of an anti-IL-5 monoclonal antibody for a critically ill patient whose condition was deteriorating despite mechanical ventilation and VV-ECMO. The usual steroid treatment failed to control the increase in blood eosinophils or his bronchial inflammation and constriction. CONCLUSION: Anti-IL-5 antibodies are now a standard treatment for severe eosinophilic asthma that can also be useful in an emergency to treat steroid-refractory eosinophilic acute severe asthma. Hindawi 2022-08-21 /pmc/articles/PMC9420636/ /pubmed/36046750 http://dx.doi.org/10.1155/2022/2180795 Text en Copyright © 2022 Nicolas Barbarot et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Barbarot, Nicolas
Nourry, Emmanuelle
Massart, Nicolas
Legay, François
Debarre, Matthieu
Fillatre, Pierre
Magalhaes, Eric
Mari, Arnaud
Wallois, Julien
Briens, Eric
Jouneau, Stéphane
Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
title Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
title_full Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
title_fullStr Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
title_full_unstemmed Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
title_short Treating Acute Severe Eosinophilic Asthma with IL-5 Inhibitors in ICU
title_sort treating acute severe eosinophilic asthma with il-5 inhibitors in icu
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420636/
https://www.ncbi.nlm.nih.gov/pubmed/36046750
http://dx.doi.org/10.1155/2022/2180795
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