Rebound eosinophilia after treatment of hypereosinophilic syndrome and eosinophilic gastroenteritis with monoclonal anti–IL-5 antibody SCH55700 Yae-Jean.

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Presentation transcript:

Rebound eosinophilia after treatment of hypereosinophilic syndrome and eosinophilic gastroenteritis with monoclonal anti–IL-5 antibody SCH55700 Yae-Jean Kim, MD, Calman Prussin, MD, Brian Martin, BS, Melissa A. Law, RN, Thomas P. Haverty, MD, Thomas B. Nutman, MD, Amy D. Klion, MD Journal of Allergy and Clinical Immunology Volume 114, Issue 6, Pages 1449-1455 (December 2004) DOI: 10.1016/j.jaci.2004.08.027 Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 1 Rebound eosinophilia after anti–IL-5 treatment. Each line shows an individual patient's changes in eosinophil counts. The dates plotted on the x-axis are not linear to show better the changes in eosinophil count observed during the early time points after treatment. Open symbols, patients with HES; solid, patients with EGE. ∗, †, 2 nonresponding patients, patients 3 and 4. Journal of Allergy and Clinical Immunology 2004 114, 1449-1455DOI: (10.1016/j.jaci.2004.08.027) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 2 Normal control and patient pretreatment in vitro eosinophil survival. Eosinophil survival was assessed in media (A) or in the presence of IL-5 (B) for patients and controls. Results are expressed as the geometric mean values for triplicate cultures for each donor. Each symbol represents 1 individual. ∗Patients with the FIP1L1/PDGFRA fusion. Journal of Allergy and Clinical Immunology 2004 114, 1449-1455DOI: (10.1016/j.jaci.2004.08.027) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 3 In vitro eosinophil survival responses before and after treatment with anti–IL-5. Eosinophil survival was assessed before and at 1 month posttreatment in media (A) and in the presence of IL-5 (B). Results are expressed as the geometric mean values for triplicate cultures for each donor. Pretreatment and posttreatment responses are indicated by gray and black bars, respectively. Journal of Allergy and Clinical Immunology 2004 114, 1449-1455DOI: (10.1016/j.jaci.2004.08.027) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 4 Prolongation of normal eosinophil survival by posttreatment patients' sera. Normal eosinophils were incubated with 1% sera from patients with HES (open symbols) or EGE (solid symbols) before and at 1 month posttreatment, and survival was assessed by flow cytometry. The horizontal bars are the median values. P=.01, Wilcoxon signed-rank test. Journal of Allergy and Clinical Immunology 2004 114, 1449-1455DOI: (10.1016/j.jaci.2004.08.027) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 5 Reversal of the prolongation of normal eosinophil survival by posttreatment serum by the rat monoclonal antihuman IL-5 antibody TRFK5. Eosinophil survival was assessed in the presence of 1% posttreatment serum from a patient with HES and increasing concentrations of TRFK5 or rat IgG1κ isotype control antibody (B). Similar data are shown using a fixed concentration of recombinant IL-5 to prolong survival (A). Journal of Allergy and Clinical Immunology 2004 114, 1449-1455DOI: (10.1016/j.jaci.2004.08.027) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions

Fig 6 Changes in serum IL-5 levels. Serum IL-5 levels are compared before and at 2 to 3 days posttreatment (A) and at 2 to 3 days and 1 month posttreatment (B) for 6 patients with HES (open) or EGE (solid). ∗, †, 2 nonresponding patients. P=.04 for comparison between 2-day to 3-day posttreatment and 1-month posttreatment serum IL-5 levels. Journal of Allergy and Clinical Immunology 2004 114, 1449-1455DOI: (10.1016/j.jaci.2004.08.027) Copyright © 2004 American Academy of Allergy, Asthma and Immunology Terms and Conditions