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. 2021 Mar 9:12:622554.
doi: 10.3389/fphar.2021.622554. eCollection 2021.

Anti-IL5 Drugs in COVID-19 Patients: Role of Eosinophils in SARS-CoV-2-Induced Immunopathology

Daniele Pala  1   2 , Marco Pistis  2   3
Affiliations

Anti-IL5 Drugs in COVID-19 Patients: Role of Eosinophils in SARS-CoV-2-Induced Immunopathology

Daniele Pala et al. Front Pharmacol. .

Abstract

SARS-CoV-2 infection stimulates a complex activation of the immune system. Eosinophils belong to the host's defense equipment against respiratory viruses. In the first phase of the infection, eosinophils contribution is probably appropriate and beneficial, as they facilitate the suppression of the viral replication. However, in severe COVID-19 patients, during the second and third phases of the disease, eosinophils may participate in a maladaptive immune response and directly contribute to immunopathology. In fact, in severe patients, the immune response is prevalently T helper 1 type, but T helper 2 is also present. Eosinophils' expansion and activation are stimulated by Type 2 cytokines, especially IL-5. Moreover, bronchial asthma, in which eosinophils play a central role, seems not to be a major risk factor for severe COVID-19. Among possible explanations, asthmatic patients are often treated with corticosteroids, which have been demonstrated to reduce the progression to critical COVID-19 in hospitalized patients. In addition to steroids, severe asthmatic patients are currently treated with biological drugs that target Type 2 immune response. Because IL-5 is necessary for the growth, survival, and activation of eosinophils, IL-5 inhibitors, such as mepolizumab, decrease the peripheral blood count of eosinophils, but do not influence eosinophils activation in the airway. In severe COVID-19 patients, the blockade of eosinophils' activation might contrast harmful immunity.

Keywords: COVID-19; anti-IL5 drugs; asthma; eosinophils; interleukin-5; type 2 response.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

    1. Acharya D., Liu G., Gack M. U. (2020). Dysregulation of type I interferon responses in COVID-19. Nat. Rev. Immunol. 20 (7), 397–398. 10.1038/s41577-020-0346-x - DOI - PMC - PubMed
    1. AstraZeneca (2018). Fasenra 30 mg solution for injection, summary of Product characteristics. Amsterdam, Netherlands: EMA.
    1. Avdeev S., Moiseev S., Brovko M., Yavorovskiy A., Umbetova K., Akulkina L., et al. (2020). Low prevalence of bronchial asthma and chronic obstructive lung disease among intensive care unit patients with COVID-19. Allergy 75, 2703–2704. 10.1111/all.14420 - DOI - PMC - PubMed
    1. Azkur A. K., Akdis M., Azkur D., Sokolowska M., van de Veen W., Brüggen M. C., et al. (2020). Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19. Allergy 75 (7), 1564–1581. 10.1111/all.14364 - DOI - PMC - PubMed
    1. Barretto K. T., Brockman-Schneider R. A., Kuipers I., Basnet S., Bochkov Y. A., Altman M. C., et al. (2020). Human airway epithelial cells express a functional IL-5 receptor. Allergy 75 (8), 2127–2130. 10.1111/all.14297 - DOI - PMC - PubMed

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