T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab

Abstract Background Targeting the interleukin‐4 receptor alpha (IL‐4Rα) subunit has proven clinical efficacy in atopic dermatitis (AD). Objective This study assessed the peripheral phenotype and function of T‐cells, but also levels of total and sIgE and its receptors in AD patients receiving dupilum...

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Main Authors: Davender Redhu, Wojciech Francuzik, Philipp Globig, Margitta Worm
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Clinical and Translational Allergy
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Online Access:https://doi.org/10.1002/clt2.70062
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author Davender Redhu
Wojciech Francuzik
Philipp Globig
Margitta Worm
author_facet Davender Redhu
Wojciech Francuzik
Philipp Globig
Margitta Worm
author_sort Davender Redhu
collection DOAJ
description Abstract Background Targeting the interleukin‐4 receptor alpha (IL‐4Rα) subunit has proven clinical efficacy in atopic dermatitis (AD). Objective This study assessed the peripheral phenotype and function of T‐cells, but also levels of total and sIgE and its receptors in AD patients receiving dupilumab. Methods AD patients were clinically assessed (n = 75) and peripheral blood samples were taken (n = 25). Multiparametric flow cytometry was performed to characterize T‐cell subsets (before treatment and 6 months later). Total and specific IgE were measured by ImmunoCap, soluble CD23 and FcεR1 in serum by ELISA, and eosinophils by differential blood analysis. Results SCORing Atopic Dermatitis scores and body surface area involvement decreased upon treatment after 6 months of treatment to 67% and 77% from baseline. At the T cell level, we observed a 0.55‐fold reduction of Th2‐cells and a mean 27% increase in regulatory T‐cells from baseline, accompanied by shifts towards Th1 and Th17 phenotypes. Furthermore, circulating CD4+CXCR5+TFH17 and CD4+CXCR5+TFH17.1 positive cells (mean 40% and 42%) and T‐cell‐specific IL‐2 (+0.96‐fold) and IL‐10 (+1.96‐fold) secretion increased, whereas IL‐4 (mean −55%) and IL‐17A (mean −27%) were reduced. Eosinophil counts (mean −22%), total IgE (mean −47%) and House Dust Mite sIgE (mean −40%) decreased, whereas CD23 and FcεR1 remained unchanged. Conclusions The T‐cell and cytokine profiles during anti‐IL4‐Ra treatment suggest that targeting this pathway promotes a systemic shift of the T‐cell compartment by reducing the T helper type 2 and complementary IgE responses. The sustainability of these disease‐modifying effects requires further investigation.
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spelling doaj-art-c3bab58acc204b69aef4c1e7f36b4a472025-08-20T03:12:05ZengWileyClinical and Translational Allergy2045-70222025-05-01155n/an/a10.1002/clt2.70062T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumabDavender Redhu0Wojciech Francuzik1Philipp Globig2Margitta Worm3Division of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDivision of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDivision of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyDivision of Allergy and Immunology Department of Dermatology, Venerology and Allergy Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin Berlin GermanyAbstract Background Targeting the interleukin‐4 receptor alpha (IL‐4Rα) subunit has proven clinical efficacy in atopic dermatitis (AD). Objective This study assessed the peripheral phenotype and function of T‐cells, but also levels of total and sIgE and its receptors in AD patients receiving dupilumab. Methods AD patients were clinically assessed (n = 75) and peripheral blood samples were taken (n = 25). Multiparametric flow cytometry was performed to characterize T‐cell subsets (before treatment and 6 months later). Total and specific IgE were measured by ImmunoCap, soluble CD23 and FcεR1 in serum by ELISA, and eosinophils by differential blood analysis. Results SCORing Atopic Dermatitis scores and body surface area involvement decreased upon treatment after 6 months of treatment to 67% and 77% from baseline. At the T cell level, we observed a 0.55‐fold reduction of Th2‐cells and a mean 27% increase in regulatory T‐cells from baseline, accompanied by shifts towards Th1 and Th17 phenotypes. Furthermore, circulating CD4+CXCR5+TFH17 and CD4+CXCR5+TFH17.1 positive cells (mean 40% and 42%) and T‐cell‐specific IL‐2 (+0.96‐fold) and IL‐10 (+1.96‐fold) secretion increased, whereas IL‐4 (mean −55%) and IL‐17A (mean −27%) were reduced. Eosinophil counts (mean −22%), total IgE (mean −47%) and House Dust Mite sIgE (mean −40%) decreased, whereas CD23 and FcεR1 remained unchanged. Conclusions The T‐cell and cytokine profiles during anti‐IL4‐Ra treatment suggest that targeting this pathway promotes a systemic shift of the T‐cell compartment by reducing the T helper type 2 and complementary IgE responses. The sustainability of these disease‐modifying effects requires further investigation.https://doi.org/10.1002/clt2.70062atopic dermatitisdupilumabIgEimmune modulationT cell phenotyping
spellingShingle Davender Redhu
Wojciech Francuzik
Philipp Globig
Margitta Worm
T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab
Clinical and Translational Allergy
atopic dermatitis
dupilumab
IgE
immune modulation
T cell phenotyping
title T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab
title_full T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab
title_fullStr T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab
title_full_unstemmed T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab
title_short T cell immunophenotypes and IgE responses in patients with moderate‐to‐severe atopic dermatitis receiving dupilumab
title_sort t cell immunophenotypes and ige responses in patients with moderate to severe atopic dermatitis receiving dupilumab
topic atopic dermatitis
dupilumab
IgE
immune modulation
T cell phenotyping
url https://doi.org/10.1002/clt2.70062
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AT philippglobig tcellimmunophenotypesandigeresponsesinpatientswithmoderatetosevereatopicdermatitisreceivingdupilumab
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