Abstract
We treated 10 cases of chronic rhinosinusitis with nasal polyps (CRSwNP) with dupilumab, an anti-IL-4/IL-13 antibody receptor drug, and examined the longitudinal changes in the levels of type 2 inflammatory markers, such as the fraction of exhaled nitric oxide (FeNO), blood eosinophil count, and serum total IgE before and after 24 weeks of dupilumab administration.
Although the FeNO decreased significantly after 24 weeks of treatment with dupilumab as compared with that before treatment, it was considered that the result reflected type 2 inflammation of the lower respiratory tract, and not directly the condition of the CRSwNP. The blood eosinophil count increased after 24 weeks of treatment, and tended to be lower in the 5 patients who received mepolizumab prior to dupilumab as compared with the 5 patients who did not receive mepolizumab. Significant decrease of the serum total IgE was observed after 24 weeks of treatment with dupilumab as compared with the level recorded prior to treatment. IL-4 receptor alpha chain gene abnormality has been shown to be associated with the serum total IgE level, and serum total IgE may be one of the indicators reflecting the effect of dupilumab on IL-4R alpha. It is a commonly performed test and a larger number of cases needs to be examined.
