Effective omalizumab treatment influenced eosinophil function in severe allergic asthmatics

Huacheng Yan; Lin Sun; Yingmeng Ni; Juan Du; Dong Liu; Ping Wang; Jin Cao; Guofang Xu; Yi Tao; Ranran Dai; Wei Tang

doi:10.21037/jtd-22-1818

Effective omalizumab treatment influenced eosinophil function in severe allergic asthmatics

J Thorac Dis. 2023 Jun 30;15(6):3115-3125. doi: 10.21037/jtd-22-1818. Epub 2023 May 22.

Authors

Huacheng Yan^#^{1

2

3}, Lin Sun^#^{1

2

3}, Yingmeng Ni^{1

2

3}, Juan Du^{1

2

3}, Dong Liu^{1

2

3}, Ping Wang¹, Jin Cao¹, Guofang Xu¹, Yi Tao¹, Ranran Dai^#^{1

2

3}, Wei Tang^#^{1

2

3}

Affiliations

¹ Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China.

^# Contributed equally.

Abstract

Background: Omalizumab is an effective anti-immunoglobulin E (IgE) treatment for allergic asthma. Eosinophil plays a critical role in the pathogenesis of allergic airway inflammation. This study aimed to explore the influence of effective omalizumab treatment on circulating eosinophils.

Methods: Allergic asthmatics enrolled in the study were treated with omalizumab for at least 16 weeks and exhibited a good or excellent response according to the global evaluation of treatment effectiveness (GETE) assessed by each patient and specialist physician. For eosinophil functional evaluation, peripheral blood eosinophils were separated; and examined the expression of human leukocyte antigen (HLA)-DR and co-stimulatory molecules cluster of differentiation (CD) 80, CD86 and CD40 by Flow Cytometry and serum were to measure the concentration of eotaxin-1 before and after 16 weeks of omalizumab treatment.

Results: Totally 32 allergic asthma patients who responded positively to omalizumab treatment were included. Omalizumab responders showed a significant decline in the expression of co-stimulatory molecules CD40, CD80, and CD86 on peripheral eosinophils and in serum eotaxin-1 concentration after treatment. Negative correlations (r=-0.61, P=0.048) were observed between the change in CD80⁺ eosinophils and the change in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC)% predicted and maximal expiratory flow (MEF) 25% after omalizumab treatment. Omalizumab improved FEV1/FVC% predicted (3.88, P=0.033), fractional exhaled nitric oxide (FeNO, -22.24, P=0.028), asthma control test (ACT, 4.22, P<0.001), mini asthma quality of life questionnaire (mini-AQLQ, -14.44, P=0.019), Leicester cough questionnaire (LCQ, 3.03, P=0.009) and visual analogue scale (VAS) for allergic symptoms (-13.00, P=0.001) in patients with severe allergic asthma statistically; reduced mini rhino-conjunctivitis quality of life questionnaire (mini-RQLQ, -8.50, P=0.047), and self-rating anxiety scale (SAS, -5.08, P=0.040) in allergic asthmatics with concomitant allergic rhinitis (AR) or anxiety, respectively.

Conclusions: Our findings show a unique role of omalizumab in reducing co-stimulatory molecules expression on eosinophil and serum eotaxin-1 levels in severe allergic asthmatics accompanied by improvement of multiple clinical parameters of allergic diseases.

Keywords: Allergic asthma; co-stimulatory molecules; eosinophil; omalizumab.