• Catherine Moermans, Chloé Brion, Grégory Bock, Sophie Graff, Sara Gerday, Haleh Nekoee, Christophe Poulet, Noémie Bricmont, Monique Henket, Virginie Paulus, Françoise Guissard, Renaud Louis, and Florence Schleich.
• Giga I3, Pneumology Research Group, Liege University, Liege, Belgium; Department of Pneumology-Allergology, CHU of Liege, Liege, Belgium. Electronic address: c.moermans@chuliege.be.
• Chest. 2023 Jun 1; 163 (6): 136813791368-1379.

BackgroundBiotherapies targeting IL-5 allow a tangible improvement of asthma. However, all patients do not respond the same way to these treatments. Even if high blood eosinophil counts seem to be associated with a reduction in exacerbations with treatment targeting IL-5, we lack biomarkers for the prediction of remission after these very expensive treatments.Research QuestionAre there biomarkers of remission after therapy targeting IL-5 in the sputum of patients with severe eosinophilic asthma?Study Design And MethodsThis observational study included 52 patients with severe asthma initiated with anti-IL-5 therapy and recruited from the asthma clinic of the Centre Hospitalier Universitaire of Liege, Belgium. Remission was defined as patients who combined the following at 1 year after therapy: no chronic treatment with oral corticosteroids; no exacerbation; asthma control questionnaire score < 1.5, asthma control test score > 19, or both; FEV1 of ≥ 80% predicted, improvement of FEV1 of ≥ 10%, or both; and a blood eosinophil count < 300 cells/μL. Eosinophil peroxidase (EPX), IgE, IL-3, IL-4, IL-5, IL-13, IL-25, IL-33, granulocyte-macrophage colony-stimulating factor, thymic stromal lymphopoietin (TSLP), and eotaxin-1 levels were measured in the sputum of these patients before anti-IL-5 treatment.ResultsAmong the 52 patients, 11 were classified as being in remission. These patients were characterized by higher sputum eosinophil, macrophage, and lymphocyte counts, whereas the sputum neutrophil percentage was lower than in the nonremission group. In addition, the sputum eotaxin-1, TSLP, IL-5, EPX, and IgE protein levels were higher at baseline in the remission group compared with the nonremission group. Univariate regression analysis revealed that male vs female sex, sputum neutrophil percentage, eotaxin-1, IL-5, and EPX were potential predictors of remission.InterpretationSputum type 2 markers seemed to be potentially predictive of remission after anti-IL-5 therapy in a cohort of patients with severe eosinophilic asthma. These results need validation on a larger cohort.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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