Mepolizumab improved airway hyperresponsiveness in a patient with allergic bronchopulmonary aspergillosis

Asian Pac J Allergy Immunol. 2021 Nov 7. doi: 10.12932/AP-030521-1125. Online ahead of print.

Abstract

Background: Allergic bronchopulmonary aspergillosis (ABPA) is a severe type of asthma characterized by hypersensitivity to Aspergillus fumigatus and lung infiltration with eosinophilia. The central pathogenesis of asthma is airway hyperresponsiveness (AHR), with eosinophils playing a critical role. Anti-interleukin (IL)-5 antibody therapy has been recently introduced to treat severe asthma, which reportedly inactivates and reduces eosinophil count. A recent case series highlighted the improvement in asthmatic symptoms associated with ABPA, but previous reports failed to demonstrate any improvement in AHR.

Objective: Herein, we aimed to elucidate the efficacy of mepolizumab in a patient with ABPA who showed improvement in AHR.

Methods: Case report.

Results: A 63-year-old Asian woman with ABPA showed improvement in asthmatic symptoms and AHR following mepolizumab therapy.

Conclusions: Our results suggest that IL-5 may serve in the pathogenesis of ABPA.