An antibody against IL-5 reduces numbers of esophageal intraepithelial eosinophils in children with eosinophilic esophagitis
| Autor: | Sandeep K. Gupta, Deborah A. Smith, Amal Assa'ad, Seema S. Aceves, T. Perschy, Jurgensen Cynthia Holder, Mike Thomson, Amy T Heath, Hector Ortega, Margaret H. Collins |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Endpoint Determination International Cooperation Antibodies Monoclonal Humanized Gastroenterology Epithelium Esophagus Double-Blind Method Internal medicine medicine Humans Eosinophilic esophagitis Prospective cohort study Child Interleukin 5 High-power field Hepatology Dose-Response Relationship Drug business.industry Interleukin Antibodies Monoclonal Eosinophilic Esophagitis Eosinophil medicine.disease Eosinophils medicine.anatomical_structure Treatment Outcome Child Preschool Female Interleukin-5 business Mepolizumab medicine.drug |
| Zdroj: | Gastroenterology. 141(5) |
| ISSN: | 1528-0012 |
| Popis: | The role of interleukin (IL)-5 in the pathogenesis of eosinophilic esophagitis (EoE) has been established in animal models; anti-IL-5 therapy has been reported to be effective in adults. We investigated whether IL-5 has a role in accumulation of esophageal eosinophils in children with EoE and whether therapy with mepolizumab, an antibody against IL-5, reduces the number of esophageal intraepithelial eosinophils in children with EoE.We performed an international, multicenter, double-blind, randomized, prospective study of 59 children with EoE, defined as baseline peak count of esophageal intraepithelial eosinophils of ≥ 20 in at least 1 high-power field (hpf). Patients received an infusion every 4 weeks (a total of 3 infusions) of 0.55, 2.5, or 10 mg/kg mepolizumab. No placebo group was used.Baseline peak and mean esophageal intraepithelial eosinophil counts were (mean ± SE) 122.5 ± 8.78 and 39.1 ± 3.63 per hpf, respectively. Four weeks after the third infusion, peak eosinophil counts were5 per hpf in 5 of 57 children (8.8%); we did not observe differences among groups given different doses of mepolizumab. Reduced peak and mean eosinophil counts, to20 per hpf, were observed in 18 of 57 (31.6%) and 51 of 57 (89.5%) children, respectively. Peak and mean esophageal intraepithelial eosinophil counts decreased significantly to 40.2 ± 5.17 and 9.3 ± 1.25 per hpf, respectively (P.0001). An analysis to evaluate predictors of response associated a higher mean baseline esophageal intraepithelial eosinophil count with a greater reduction in mean count (P.0001).IL-5 is involved in the pathogenesis of EoE in children. Mepolizumab, an antibody against IL-5, reduces esophageal eosinophilic inflammation in these patients. |
| Databáze: | OpenAIRE |
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