Targeting the interleukin-5 pathway improves cough hypersensitivity in patients with severe uncontrolled asthma.

Abstract

BACKGROUND:

Capsaicin cough sensitivity (C-CS) reflects airway neuronal dysfunction and may be a significant biomarker of asthma. Although mepolizumab reduces cough in patients with severe uncontrolled asthma, it is unclear whether the cough reduction is associated with improved C-CS.

OBJECTIVE:

To clarify the effect of biologics on C-CS and cough-specific quality of life (QoL) in patients with severe uncontrolled asthma using our previous study cohort.

METHODS:

Overall, 52 consecutive patients who visited our hospital for severe uncontrolled asthma were included in the original study cohort, and 30 patients were eligible for this study. Changes in C-CS and cough-specific QoL were compared between patients treated with the anti-interleukin-5 (IL-5) pathway (n = 16) and those treated with other biologics (n = 14). The C-CS was measured as the concentration of capsaicin required to induce at least 5 coughs.

RESULTS:

Biologics significantly improved C-CS (P = .03). Anti-IL-5 pathway therapies significantly improved C-CS, whereas other biologics did not (P < .01 and P = .89, respectively). The C-CS improved significantly more in the anti-IL-5 pathway group than in the group treated with other biologics (P = .02). Changes in C-CS significantly correlated with improvements in cough-specific QoL in the anti-IL-5 pathway group (r = 0.58, P = .01) but not in the group treated with other biologics (r = 0.35, P = .22).

CONCLUSION:

Anti-IL-5 pathway therapies improve C-CS and cough-specific QoL, and targeting the IL-5 pathway may be a therapeutic strategy for cough hypersensitivity in patients with severe uncontrolled asthma.

• Authors: Keima Ito, Yoshihiro Kanemitsu, Kensuke Fukumitsu, Tomoko Tajiri, Hirono Nishiyama, Yuta Mori, Satoshi Fukuda, Takehiro Uemura, Hirotsugu Ohkubo, Ken Maeno, Yutaka Ito, Tetsuya Oguri, Masaya Takemura, Akio Niimi
• Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology (Ann Allergy Asthma Immunol) Vol. 131 Issue 2 Pg. 203-208.e1 (08 2023) ISSN: 1534-4436 [Electronic] United States
• PMID: 37100279 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Chemical References

• IL5 protein, human
• Interleukin-5
• Biological Products
• Capsaicin

Topics

• Humans
• Cough (drug therapy)
• Asthma (drug therapy)
• Interleukin-5 (antagonists & inhibitors)
• Biological Products (therapeutic use)
• Capsaicin
• Quality of Life
• Male
• Female
• Adult
• Middle Aged
• Aged