Allergic bronchopulmonary aspergillosis in a lung transplant recipient treated with mepolizumab

IF 4.5 3区 医学 Q2 IMMUNOLOGY Clinical immunology Pub Date : 2024-05-25 DOI:10.1016/j.clim.2024.110265
Foteini Ioakeim , Christophe Abellan , Alessio Casutt , Benoit Lechartier , Leslie Noirez , Catherine Beigelman-Aubry , John-David Aubert , Zisis Balmpouzis , Angela Koutsokera
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Abstract

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus spp. ABPA diagnosis may be challenging due to its non-specific presentation. Standard ABPA treatment consists of systemic corticosteroids and antifungal agents. Mepolizumab, a monoclonal antibody against interleukin-5 seems to be a promising treatment for ABPA. Data about ABPA following lung transplantation (LuTx) are scarce. LuTx recipients are at higher risk for adverse effects of ABPA treatment compared to the general population.

Here we present a case of a LuTx recipient who was successfully treated with mepolizumab for ABPA following LuTx. Prolonged administration of high dose prednisone was thus avoided. To our knowledge, this is the first case describing mepolizumab administration following LuTx. Mepolizumab seems particularly attractive as a corticosteroid-sparing agent or as an alternative option to antifungal treatments, because of its excellent safety profile and low risk of drug interactions.

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一名肺移植受者在接受甲泼尼珠单抗治疗后出现过敏性支气管肺曲霉病。
过敏性支气管肺曲霉菌病(ABPA)是一种对曲霉菌属的复杂超敏反应。标准的 ABPA 治疗包括全身使用皮质类固醇激素和抗真菌药物。抗白细胞介素-5 的单克隆抗体 Mepolizumab 似乎是治疗 ABPA 的一种很有前景的方法。有关肺移植(LuTx)后 ABPA 的数据很少。与普通人群相比,肺移植受者出现 ABPA 治疗不良反应的风险更高。在此,我们介绍了一例在肺移植术后使用甲泼尼单抗成功治疗 ABPA 的病例。因此避免了长期使用大剂量泼尼松。据我们所知,这是第一例描述 LuTx 术后使用美妥珠单抗的病例。由于美妥珠单抗具有极佳的安全性和较低的药物相互作用风险,因此作为一种皮质类固醇替代药物或抗真菌治疗的替代选择似乎特别有吸引力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical immunology
Clinical immunology 医学-免疫学
CiteScore
12.30
自引率
1.20%
发文量
212
审稿时长
34 days
期刊介绍: Clinical Immunology publishes original research delving into the molecular and cellular foundations of immunological diseases. Additionally, the journal includes reviews covering timely subjects in basic immunology, along with case reports and letters to the editor.
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