Extract
We read with interest the report by Dagher et al. [1] of a novel anti-eosinophil action of benralizumab. Benralizumab was shown to induce eosinophil apoptosis by a macrophage-derived tumour necrosis factor (TNF)-induced caspase 3/7 activation, and this was amplified by interferon-γ (IFN-γ) secreted from natural killer (NK) cells. Indeed, in patients with severe asthma, including those who are dependent on daily systemic glucocorticosteroids for asthma control, benralizumab effectively depletes sputum eosinophils [2]. Although no direct head-to-head comparisons have been made, eosinophil suppression is likely to be greater than with the currently approved dose of mepolizumab [3], leading to greater clinical efficacy [4]. However, there may be instances when the anti-eosinophil activity of benralizumab may be impaired due to decreased NK cell numbers or activity that are described in patients with severe asthma on high doses of glucocorticosteroids [5].
Abstract
Although likely to be exceedingly rare, impaired ADCC due to NK cell dysfunction needs to be considered as one of the reasons, along with the development of anti-drug neutralising antibodies, for impaired anti-eosinophil activity of benralizumab https://bit.ly/3nxeFVg
Footnotes
Conflict of interest: S.M. Poznanski has nothing to disclose.
Conflict of interest: A. Portillo has nothing to disclose.
Conflict of interest: M. Mukherjee has salary support from Canadian Allergy Asthma Foundation, grant support from Methapharam and Canadian Institutes of Health Research, and has received personal fees from AstraZeneca and GlaxoSmithKline.
Conflict of interest: A. Bhalla has nothing to disclose.
Conflict of interest: K. Son has nothing to disclose.
Conflict of interest: A.A. Ashkar has nothing to disclose.
Conflict of interest: N. Khalidi has nothing to disclose.
Conflict of interest: P. Nair is supported by the Frederick E. Hargreave Teva Innovation Chair in Airway Diseases; and reports grant support from Sanofi Genzyme, AstraZeneca, Teva, Foresee, Equillium and Cyclomedica, and personal fees from AstraZeneca, Teva, Equillium, Arrowhead, GlaxoSmithKline and Sanofi Genzyme.
- Received August 11, 2021.
- Accepted November 15, 2021.
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