Levels of CC motif chemokine 22 (CCL22), IL-13, and CXCL10, but not
levels of IL-5, predict response to mepolizumab in asthma
Abstract
To date, most studies of response to the anti-interleukin 5 agent,
mepolizumab, has identified eosinophils as the main clinical biomarker
of response. However, many patients with eosinophilic asthma still fail
to demonstrate clinical response to mepolizumab. In this study, we
evaluate the association of 26 cytokines and chemokines, including
T-helper 1 (Th1)-, Th2-, Th17-related cytokines and alarmins, with
response to mepolizumab. We defined clinical response to mepolizumab as
a reduction in the baseline annual exacerbation rate by at least half
over the one-year period following initiation of mepolizumab. Our
results suggest that, asides the peripheral eosinophil count, the levels
of the CC motif chemokine 22 (CCL22), IL-13, and CXCL10, but not levels
of IL-5, were higher in responders. These three and IL-17F, IL-23, and
IL-8 had the greatest differential between responders and nonresponders
to mepolizumab. Cytokines and chemokines associated with airway
eosinophilia, such as CCL22 and CXCL10, may be better predictors of
clinical response to mepolizumab than IL-5, the target of mepolizumab.