Cargando…
The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion
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 do...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471022/ https://www.ncbi.nlm.nih.gov/pubmed/36103081 http://dx.doi.org/10.1007/s11882-022-01039-w |
_version_ | 1784788972821544960 |
---|---|
author | Milne, Megan E. Kimball, Jack Tarrant, Teresa K. Al-Rohil, Rami N. Leverenz, David L. |
author_facet | Milne, Megan E. Kimball, Jack Tarrant, Teresa K. Al-Rohil, Rami N. Leverenz, David L. |
author_sort | Milne, Megan E. |
collection | PubMed |
description | 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 clinical consequences of inhibiting these individual cytokines in eGPA. RECENT FINDINGS: Treatments for eosinophilic granulomatosis with polyangiitis (eGPA) are rapidly evolving through using biologic therapies to modulate the Th2 inflammatory response via eosinophil inhibition. While IL-4, IL-5, IL-13, and IL-25 can all affect eosinophils, only IL-5 inhibition has demonstrated therapeutic benefit to-date. In this review, we report a clinical vignette of a patient with adult-onset asthma who developed severe manifestations of eGPA after switching from mepolizumab (an IL-5 inhibitor) to dupilumab (an inhibitor of IL-4 and IL-13). SUMMARY: By understanding the role of IL-4, IL-5, and IL-13 in Th2-mediated vasculitis, we can start to understand how eGPA might respond differently to focused cytokine inhibition. |
format | Online Article Text |
id | pubmed-9471022 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-94710222022-09-14 The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion Milne, Megan E. Kimball, Jack Tarrant, Teresa K. Al-Rohil, Rami N. Leverenz, David L. Curr Allergy Asthma Rep Immunotherapy and Immunomodulators (B Vickery, Section Editor) 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 clinical consequences of inhibiting these individual cytokines in eGPA. RECENT FINDINGS: Treatments for eosinophilic granulomatosis with polyangiitis (eGPA) are rapidly evolving through using biologic therapies to modulate the Th2 inflammatory response via eosinophil inhibition. While IL-4, IL-5, IL-13, and IL-25 can all affect eosinophils, only IL-5 inhibition has demonstrated therapeutic benefit to-date. In this review, we report a clinical vignette of a patient with adult-onset asthma who developed severe manifestations of eGPA after switching from mepolizumab (an IL-5 inhibitor) to dupilumab (an inhibitor of IL-4 and IL-13). SUMMARY: By understanding the role of IL-4, IL-5, and IL-13 in Th2-mediated vasculitis, we can start to understand how eGPA might respond differently to focused cytokine inhibition. Springer US 2022-09-14 2022 /pmc/articles/PMC9471022/ /pubmed/36103081 http://dx.doi.org/10.1007/s11882-022-01039-w Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Immunotherapy and Immunomodulators (B Vickery, Section Editor) Milne, Megan E. Kimball, Jack Tarrant, Teresa K. Al-Rohil, Rami N. Leverenz, David L. The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion |
title | The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion |
title_full | The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion |
title_fullStr | The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion |
title_full_unstemmed | The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion |
title_short | The Role of T Helper Type 2 (Th2) Cytokines in the Pathogenesis of Eosinophilic Granulomatosis with Polyangiitis (eGPA): an Illustrative Case and Discussion |
title_sort | role of t helper type 2 (th2) cytokines in the pathogenesis of eosinophilic granulomatosis with polyangiitis (egpa): an illustrative case and discussion |
topic | Immunotherapy and Immunomodulators (B Vickery, Section Editor) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471022/ https://www.ncbi.nlm.nih.gov/pubmed/36103081 http://dx.doi.org/10.1007/s11882-022-01039-w |
work_keys_str_mv | AT milnemegane theroleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT kimballjack theroleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT tarrantteresak theroleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT alrohilramin theroleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT leverenzdavidl theroleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT milnemegane roleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT kimballjack roleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT tarrantteresak roleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT alrohilramin roleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion AT leverenzdavidl roleofthelpertype2th2cytokinesinthepathogenesisofeosinophilicgranulomatosiswithpolyangiitisegpaanillustrativecaseanddiscussion |