The Role of Benralizumab in Eosinophilic Immune Dysfunctions: A Case Report-Based Literature Review.

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL Case Reports in Medicine Pub Date : 2023-04-24 eCollection Date: 2023-01-01 DOI:10.1155/2023/8832242
Margarida Gomes, Ana Mendes, Filipa Ferreira, Joana Branco, Fernanda S Tonin, M Elisa Pedro
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引用次数: 3

Abstract

In the past years, the knowledge of eosinophils playing a primary pathophysiologic role in several associated conditions has led to the development of biologics targeting therapies aiming at normalizing the immune response, reducing chronic inflammation, and preventing tissue damage. To better illustrate the potential relationship between different eosinophilic immune dysfunctions and the effects of biological therapies in this scenario, here, we present a case of a 63-year-old male first referred to our department in 2018 with a diagnosis of asthma, polyposis, and rhinosinusitis and presenting a suspicion of nonsteroidal anti-inflammatory drugs' allergy. He also had a past medical history of eosinophilic gastroenteritis/duodenitis (eosinophilia counts >50 cells/high-power field HPF). The use of multiple courses of corticosteroid therapy failed to completely control these conditions. In October 2019, after starting benralizumab (an antibody directed against the alpha chain of the IL-5 cytokine receptor) as add-on treatment for severe eosinophilic asthma, important clinical improvements were reported both on the respiratory (no asthma exacerbations) and gastrointestinal systems (eosinophilia count 0 cells/HPF). Patients' quality of life also increased. Since June 2020, systemic corticosteroid therapy was reduced without worsening of gastrointestinal symptoms or eosinophilic inflammation. This case warns of the importance of early recognition and appropriate individualized treatment of eosinophilic immune dysfunctions and suggests the conduction of further larger studies on the use of benralizumab in gastrointestinal syndromes aiming at better understanding its relying mechanisms of action in the intestinal mucosa.

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Benralizumab在嗜酸性免疫功能障碍中的作用:基于病例报告的文献综述。
在过去的几年里,嗜酸性粒细胞在几种相关疾病中发挥主要病理生理作用的知识导致了生物制剂靶向疗法的发展,旨在使免疫反应正常化,减少慢性炎症,防止组织损伤。为了更好地说明不同嗜酸性粒细胞免疫功能障碍与生物疗法在这种情况下的影响之间的潜在关系,我们在这里介绍了一例63岁的男性,他于2018年首次转诊到我们的科室,诊断为哮喘、息肉病和鼻窦炎,并怀疑非甾体抗炎药过敏。他也有嗜酸性肠胃炎/十二指肠炎病史(嗜酸性粒细胞计数>50 单元/高功率场HPF)。使用多个疗程的皮质类固醇治疗未能完全控制这些情况。2019年10月,在开始使用benralizumab(一种针对IL-5细胞因子受体α链的抗体)作为严重嗜酸性粒细胞性哮喘的附加治疗后,据报道,呼吸系统(没有哮喘恶化)和胃肠系统(嗜酸性粒数为0 细胞/HPF)。患者的生活质量也有所提高。自2020年6月以来,系统性皮质类固醇治疗减少,胃肠道症状或嗜酸性粒细胞炎症没有恶化。该病例警告了早期识别和适当个体化治疗嗜酸性粒细胞免疫功能障碍的重要性,并建议对benralizumab在胃肠道综合征中的应用进行进一步的大规模研究,以更好地了解其在肠粘膜中的依赖作用机制。
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
Case Reports in Medicine
Case Reports in Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.70
自引率
0.00%
发文量
53
审稿时长
13 weeks
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