IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma

Background Asthma is a heterogeneous disease with variable response to treatment. Genetic backgrounds are involved in the severity of type 2 asthma, but their effects on responses to biologics remain unknown. This study aimed to clarify the role of genetic factors in response to biologics in patient...

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Main Authors: Kenta Nishi, Hisako Matsumoto, Hironobu Sunadome, Tadao Nagasaki, Tsuyoshi Oguma, Noriyuki Tashima, Yusuke Hayashi, Satoru Terada, Kyohei Morita, Chie Yoshimura, Yasuo Nishizaka, Akiko Sano, Takashi Iwanaga, Hiroyuki Sano, Ryuta Haraguchi, Yuji Tohda, Takahisa Kawaguchi, Fumihiko Matsuda, Toyohiro Hirai
Format: Article
Language:English
Published: European Respiratory Society 2025-01-01
Series:ERJ Open Research
Online Access:http://openres.ersjournals.com/content/11/1/00448-2024.full
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author Kenta Nishi
Hisako Matsumoto
Hironobu Sunadome
Tadao Nagasaki
Tsuyoshi Oguma
Noriyuki Tashima
Yusuke Hayashi
Satoru Terada
Kyohei Morita
Chie Yoshimura
Yasuo Nishizaka
Akiko Sano
Takashi Iwanaga
Hiroyuki Sano
Ryuta Haraguchi
Yuji Tohda
Takahisa Kawaguchi
Fumihiko Matsuda
Toyohiro Hirai
author_facet Kenta Nishi
Hisako Matsumoto
Hironobu Sunadome
Tadao Nagasaki
Tsuyoshi Oguma
Noriyuki Tashima
Yusuke Hayashi
Satoru Terada
Kyohei Morita
Chie Yoshimura
Yasuo Nishizaka
Akiko Sano
Takashi Iwanaga
Hiroyuki Sano
Ryuta Haraguchi
Yuji Tohda
Takahisa Kawaguchi
Fumihiko Matsuda
Toyohiro Hirai
author_sort Kenta Nishi
collection DOAJ
description Background Asthma is a heterogeneous disease with variable response to treatment. Genetic backgrounds are involved in the severity of type 2 asthma, but their effects on responses to biologics remain unknown. This study aimed to clarify the role of genetic factors in response to biologics in patients with severe asthma. Methods Adults with severe asthma receiving biologics were enrolled in this multicentre, observational, real-world study. The responses to biologics were evaluated using Physicians’ Global Evaluation of Treatment Effectiveness (GETE). Optimal biologic for each patient was also determined based on the best GETE score for the biologic used or currently used biologic. Three single nucleotide polymorphisms (IL1RL1, rs1420101; IL4RA, rs8832; and TSLP rs1837253) were examined. Results Among the 113 patients analysed, 53 (46.9%) had an excellent GETE score for at least one biologic. These patients with an excellent GETE score for at least one biologic, particularly for benralizumab, had the risk genotype of rs1420101 more frequently than the remaining patients, independent of the clinical demographics. Regarding the optimal biologic for each patient, anti-IL-5 drugs were optimal for patients with the rs1420101 TT or rs8832 GG genotype. Furthermore, dupilumab was similarly effective, regardless of the risk genotypes examined in this study. Conclusion IL1RL1 rs1420101 TT genotype and/or IL4RA rs8832 GG genotype may predict an excellent or optimal response to biologic therapy in each patient, particularly to anti-interleukin-5 targeted therapy. The elucidation of genetic predisposition may improve the management of severe asthma in the era of biologics.
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spelling doaj-art-1e2fe7aacc2a4c21b91be30676d7352b2025-08-20T03:02:16ZengEuropean Respiratory SocietyERJ Open Research2312-05412025-01-0111110.1183/23120541.00448-202400448-2024IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthmaKenta Nishi0Hisako Matsumoto1Hironobu Sunadome2Tadao Nagasaki3Tsuyoshi Oguma4Noriyuki Tashima5Yusuke Hayashi6Satoru Terada7Kyohei Morita8Chie Yoshimura9Yasuo Nishizaka10Akiko Sano11Takashi Iwanaga12Hiroyuki Sano13Ryuta Haraguchi14Yuji Tohda15Takahisa Kawaguchi16Fumihiko Matsuda17Toyohiro Hirai18 Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Osaka Red Cross Hospital, Osaka, Japan Department of Respiratory Medicine, Osaka Red Cross Hospital, Osaka, Japan Department of Respiratory Medicine, Osaka Red Cross Hospital, Osaka, Japan Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osaka, Japan Center for General Medical Education and Clinical Training, Kindai University Hospital, Osaka, Japan Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osaka, Japan Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, Osaka, Japan Kindai University Hospital, Osaka, Japan Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Respiratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan Background Asthma is a heterogeneous disease with variable response to treatment. Genetic backgrounds are involved in the severity of type 2 asthma, but their effects on responses to biologics remain unknown. This study aimed to clarify the role of genetic factors in response to biologics in patients with severe asthma. Methods Adults with severe asthma receiving biologics were enrolled in this multicentre, observational, real-world study. The responses to biologics were evaluated using Physicians’ Global Evaluation of Treatment Effectiveness (GETE). Optimal biologic for each patient was also determined based on the best GETE score for the biologic used or currently used biologic. Three single nucleotide polymorphisms (IL1RL1, rs1420101; IL4RA, rs8832; and TSLP rs1837253) were examined. Results Among the 113 patients analysed, 53 (46.9%) had an excellent GETE score for at least one biologic. These patients with an excellent GETE score for at least one biologic, particularly for benralizumab, had the risk genotype of rs1420101 more frequently than the remaining patients, independent of the clinical demographics. Regarding the optimal biologic for each patient, anti-IL-5 drugs were optimal for patients with the rs1420101 TT or rs8832 GG genotype. Furthermore, dupilumab was similarly effective, regardless of the risk genotypes examined in this study. Conclusion IL1RL1 rs1420101 TT genotype and/or IL4RA rs8832 GG genotype may predict an excellent or optimal response to biologic therapy in each patient, particularly to anti-interleukin-5 targeted therapy. The elucidation of genetic predisposition may improve the management of severe asthma in the era of biologics.http://openres.ersjournals.com/content/11/1/00448-2024.full
spellingShingle Kenta Nishi
Hisako Matsumoto
Hironobu Sunadome
Tadao Nagasaki
Tsuyoshi Oguma
Noriyuki Tashima
Yusuke Hayashi
Satoru Terada
Kyohei Morita
Chie Yoshimura
Yasuo Nishizaka
Akiko Sano
Takashi Iwanaga
Hiroyuki Sano
Ryuta Haraguchi
Yuji Tohda
Takahisa Kawaguchi
Fumihiko Matsuda
Toyohiro Hirai
IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma
ERJ Open Research
title IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma
title_full IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma
title_fullStr IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma
title_full_unstemmed IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma
title_short IL1RL1 variant may affect the response to type 2 biologics in patients with severe asthma
title_sort il1rl1 variant may affect the response to type 2 biologics in patients with severe asthma
url http://openres.ersjournals.com/content/11/1/00448-2024.full
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