Dupilumab treatment decreases MBC2s, correlating with reduced IgE levels in pediatric atopic dermatitis.
J Allergy Clin Immunol
; 2024 Jul 20.
Article
in En
| MEDLINE
| ID: mdl-39038586
ABSTRACT
BACKGROUND:
A preference for type 2 immunity plays a central role in the pathogenesis of atopic dermatitis (AD). Dupilumab, an mAb targeting the IL-4 receptor α (IL-4Rα) subunit, inhibits IL-4 and IL-13 signaling. These cytokines contribute significantly to IgE class switch recombination in B cells, critical in atopic diseases. Recent studies indicate IgG+CD23hiIL-4Rα+ type 2 memory B cells (MBC2s) as IgE-producing B-cell precursors, linked to total IgE serum levels in atopic patients. Total IgE serum levels decreased during dupilumab treatment in previous studies.OBJECTIVE:
We sought to assess the effects of dupilumab treatment in comparison with alternative therapies on the frequency of MBC2s and the correlation to total IgE levels in pediatric patients with AD.METHODS:
Pediatric patients with AD, participating in an ongoing trial, underwent randomization into 3 treatment groups dupilumab (n = 12), cyclosporine (n = 12), and topical treatment (n = 12). Plasma samples and PBMCs were collected at baseline (T0) and at 6 months after starting therapy (T6). Flow cytometry was used for PBMC phenotyping, and ELISA was used to assess total IgE levels in plasma.RESULTS:
Our findings revealed a significant reduction in MBC2 frequency and total IgE levels among patients treated with dupilumab. In addition, a significant correlation was observed between MBC2s and total IgE levels.CONCLUSIONS:
Systemic blocking of the IL-4Rα subunit leads to a decrease in circulating MBC2 cells and total IgE levels in pediatric patients with AD. Our findings unveiled a novel mechanism through which dupilumab exerts its influence on the atopic signature.
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Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Allergy Clin Immunol
Year:
2024
Document type:
Article
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