Reviews and Feature Articles: Rapid PublicationsAnti–IL-5 (mepolizumab) therapy induces bone marrow eosinophil maturational arrest and decreases eosinophil progenitors in the bronchial mucosa of atopic asthmatics☆
Section snippets
Study design
The clinical study of anti–IL-5 (mepolizumab) in asthma has previously been described.18 In brief, 24 volunteers with mild asthma were recruited to a 2-center, double blind, placebo-controlled, parallel-group study. At baseline, venous blood sampling, bone marrow aspiration, and fiberoptic bronchoscopy with endobronchial biopsy were performed. Two days later, the study medication (750 mg mepolizumab) or an equal volume of placebo was given as an intravenous infusion in a double-blind fashion.
Results
Eleven volunteers were randomized to receive mepolizumab, and 13 volunteers were randomized to receive placebo.
Discussion
We have demonstrated that IL-5 blockade with mepolizumab significantly reduced terminal differentiation of eosinophils (myelocytes, metamyelocytes, and mature eosinophils) within the bone marrow but had no significant overall effect on numbers of early eosinophil progenitors (CD34+/IL-5Rα+ cells or Eo/B-CFUs). Anti–IL-5 also significantly decreased numbers of CD34+/IL-5Rα mRNA+ cells in the bronchial mucosa. These findings are compatible with anti–IL-5–induced maturational arrest of bone marrow
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Reprint requests: Judah Denburg, MD, Department of Medicine, McMaster University, HSC 3V46, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5.