Targeting IL-5 pathway against airway hyperresponsiveness: A comparison between benralizumab and mepolizumab

Luigino Calzetta, Beatrice Ludovica Ritondo, Maria Gabriella Matera, Francesco Facciolo, Paola Rogliani

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Purpose: Airway hyperresponsiveness (AHR) is a central abnormality in asthma. IL-5 may modulate AHR in animal models of asthma, but the available data is inconsistent on the impact of targeting IL-5 pathway against AHR. The difference between targeting IL-5 or the IL-5 receptor, α subunit (IL-5Rα) in modulating AHR remains to be investigated in human airways. The aim of this study was to compare the role of the anti-IL-5Rα benralizumab and the anti-IL-5 mepolizumab against AHR and to assess whether these agents influence the levels of cAMP. Experimental Approach: Passively sensitized human airways were treated with benralizumab and mepolizumab. The primary endpoint was the inhibition of AHR to histamine. The secondary endpoints were the protective effect against AHR to parasympathetic activation and mechanical stress, and the tissue modulation of cAMP. Key Results: Benralizumab and mepolizumab significantly inhibited the AHR to histamine (maximal effect −134.14 ± 14.93% and −108.29 ± 32.16%, respectively), with benralizumab being 0.73 ± 0.10 logarithm significantly more potent than mepolizumab. Benralizumab and mepolizumab significantly inhibited the AHR to transmural stimulation and mechanical stress. Benralizumab was 0.45 ± 0.16 logarithm significantly more potent than mepolizumab against AHR to parasympathetic activation. The effect of these agents was significantly correlated with increased levels of cAMP. Conclusion and Implications: Targeting the IL-5/IL-5Rα axis is an effective strategy to prevent the AHR. Benralizumab was more potent than the mepolizumab and the concentration-dependent beneficial effects of both these monoclonal antibodies were related to improved levels of cAMP in hyperresponsive airways.

Original languageEnglish
Pages (from-to)4750-4765
Number of pages16
JournalBritish Journal of Pharmacology
Volume177
Issue number20
DOIs
Publication statusPublished - Oct 1 2020

Keywords

  • airway hyperresponsiveness
  • airway smooth muscle
  • benralizumab
  • head to head
  • IL-5
  • mepolizumab
  • severe asthma

ASJC Scopus subject areas

  • Pharmacology

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