Free serum IL-18 levels and responsiveness to omalizumab in patients with severe asthma
Tomoko Tajiri (Kyoto-shi, Japan), Tomoko Tajiri, Hisako Matsumoto, Yasuhiro Gon, Reiko Ito, Shu Hashimoto, Kenji Izuhara, Junya Ono, Shoichiro Ohta, Isao Ito, Tsuyoshi Oguma, Hideki Inoue, Toshiyuki Iwata, Tadao Nagasaki, Yoshihiro Kanemitsu, Akio Niimi, Michiaki Mishima
Source: International Congress 2016 – Asthma: mechanisms and biomarkers that promote clinical understanding
Disease area: Airway diseases
Abstract Introduction : Elevated Th2 biomarkers may predict efficient reduction in exacerbations during the 1st year of omalizumab treatment. Recent studies of long-term treatment with omalizumab suggest the presence of late responders, of which predictive markers remain unknown. Here we hypothesized that interleukin-18 (IL-18), a cytokine inducing IFN-g from Th1 cells but also enhancing production of Th2 cytokines, may be a marker of late responders that show gradual reduction in exacerbations.Objectives : In this prospective and observational study, we assessed the association between baseline serum free IL-18 (fIL-18) and late response to omalizumab treatment in allergic patients with severe asthma.Methods : Patients who had completed 2 years of omalizumab treatment were recruited. At baseline, serum fIL-18 levels, in addition to Th2 biomarkers including serum periostin, were determined. Association between serum fIL-18 levels and response to treatment was assessed.Results : We enrolled 27 patients (19 females, average55.7 years old). Baseline serum IgE levels were plotted against serum fIL-18 levels in inverted V-shape. When patients were divided into 3 equal parts according to their serum fIL-18 levels, patients with top third range of serum fIL-18 showed the lowest blood eosinophil counts and serum periostin levels. They had asthma exacerbations during 1 year before and after omalizumab treatment more frequently than the remaining, but showed gradual and significant reduction in number of exacerbations over 2 years of treatment.Conclusions : Baseline serum fIL-18 levels may be associated with late response to omalizumab treatment in allergic patients with severe asthma.
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Tomoko Tajiri (Kyoto-shi, Japan), Tomoko Tajiri, Hisako Matsumoto, Yasuhiro Gon, Reiko Ito, Shu Hashimoto, Kenji Izuhara, Junya Ono, Shoichiro Ohta, Isao Ito, Tsuyoshi Oguma, Hideki Inoue, Toshiyuki Iwata, Tadao Nagasaki, Yoshihiro Kanemitsu, Akio Niimi, Michiaki Mishima. Free serum IL-18 levels and responsiveness to omalizumab in patients with severe asthma. Eur Respir J 2016; 48: Suppl. 60, 575
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