Targeted Anti-IL-5 Therapies and Future Therapeutics for Hypereosinophilic Syndrome and Rare Eosinophilic Conditions
Eosinophilic inflammation is a component of many atopic diseases such as asthma, and biologics targeting eosinophils have been shown to be effective in subsets of these patients. However, there also are conditions in which eosinophils are the key inflammatory cells responsible for driving tissue damage. In these eosinophilic diseases such as hyper-eosinophilic syndrome, eosinophilic esophagitis, and eosinophilic granulomatosis with polyangiitis (EGPA), the development of biologics inhibiting eosinophilic inflammation have offered targeted therapeutic strategies for patients that have not responded well to typical first line drugs, which often have significant adverse side effects with poor disease modification or recurrent relapse with significant morbidity. IL-5 has long been recognized as the key inflammatory cytokine involved in the priming and survival of eosinophils and their proliferation and maturation in eosinophilic disease. There are a number of trials and case series demonstrating the immunomodulatory benefits of anti-IL-5 therapies in these diseases with good clinical responses. Yet, due to the heterogeneity and rarity of these conditions, anti-IL-5 therapies have not resulted in disease remission for all patients. Clearly, further research into the use of anti-IL-5 therapies in various eosinophilic diseases is needed and ongoing investigation into other immune mechanisms underlying chronic eosinophilic diseases may provide alternative therapies for these challenging conditions.
KeywordsBenralizumab Mepolizumab Reslizumab Siglec-8 Hypereosinophilic syndrome Eosinophilic esophagitis Eosinophilic granulomatosis with polyangiitis Dermatitis Eosinophilia IL-5 IL-4 IL-13
Compliance with Ethical Standards
Conflict of Interest
Author Aasha Harish, MD, MPH declares that she does not have any conflict of interest. Author Stanley Schwartz, MD, PhD received a speaker honorarium from Takeda Pharmaceutical Co and CSL Behring and owns stock in Pfizer Pharmaceutical Co and Merck Pharmaceutical Co.
Research with animals and human subjects: This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent: This authors of this article were not involved in the enrollment of subjects used of studies reported. Informed consent was obtained from all individual participants included in the study.
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