Anti–IL-5 treatment improves airway remodeling in asthmatic individuals

Articles of note . . . Anti–IL-5 treatment improves airway remodeling in asthmatic individuals The results of initial clinical trials with humanized anti–IL-5 therapy for asthma have been disappointing, because disease parameters were not markedly improved by this therapy. However, in this report, the investigators examined markers of airway remodeling in 24 mildly asthmatic individuals treated with anti–IL-5 (mepolizumab) or placebo. Bronchial biopsy specimens were obtained before or after 3 monthly infusions of anti–IL-5. Notably, multiple markers of airway remodeling were statistically improved in the treatment group compared with the placebo group. In particular, the abnormal expression of extracellular matrix molecules tenascin, lumican, and procollagen III in the bronchial mucosal reticular basement membrane was improved. In addition, anti–IL-5 treatment significantly reduced the numbers of airway eosinophils expressing mRNA for TGF-β1 and the concentration of TGF-β1 in bronchoalveolar lavage fluid. These results are remarkable in view of the only modest reduction in lung eosinophilia (~55%) induced by this therapy. These results, combined with the finding reported in this issue of the JACI (p 115) that the same anti–IL-5 reagent might be helpful for hypereosinophilic syndromes, raise renewed interest in the pharmacologic potential of mepolizumab and related antieosinophil/IL-5 agents. (Flood-Page et al. J Clin Invest 2003;112:1029-36.)

January 2000 J ALLERGY CLIN IMMUNOL

Beyond Our Pages Burton Zweiman, MD, & Marc E. Rothenberg, MD, PhD, Editors

J ALLERGY CLIN IMMUNOL January 2004

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