使用类固醇和杜比鲁单抗联合治疗杜比鲁单抗引起的嗜酸性粒细胞性肺炎后的嗜酸性粒细胞性慢性鼻窦炎

IF 17.7 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2025-03-01 Epub Date: 2022-07-13 DOI:10.1177/01455613221115043
Takato Sudo, Takeshi Tsuda, Masaki Hayama, Kazuya Takeda, Sho Obata, Ayaka Nakatani, Yuta Amano, Soichiro Fujii, Hiroko Fukata, Hidenori Inohara
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引用次数: 0

摘要

嗜酸性粒细胞慢性鼻炎(ECRS)是一种表现为副鼻窦慢性炎症的2型炎症性疾病。抑制2型炎症的IL-4/IL-13受体单克隆抗体(dupilumab)已成为手术难治患者的良好治疗选择。大多数患者反应正常,但也可能出现嗜酸性粒细胞肺炎等严重副作用,需要停用双鲁单抗。在此,我们介绍一例使用杜比单抗导致嗜酸性粒细胞肺炎副作用的病例。一名 65 岁的妇女因鼻息肉导致鼻塞和嗅觉功能障碍。使用杜比卢单抗后,她的症状暂时得到改善;但由于嗜酸性粒细胞肺炎,她停用了杜比卢单抗。停用杜比鲁单抗后,嗜酸性粒细胞肺炎迅速缓解,鼻息肉再次出现。因此,我们恢复了双鲁单抗与小剂量类固醇的联合治疗,结果嗜酸性粒细胞肺炎没有复发,鼻息肉也稳步缩小。对于在使用杜比单抗治疗 ECRS 期间出现嗜酸性粒细胞肺炎副作用的病例,目前尚无既定的治疗策略。根据上述病例,我们建议考虑将小剂量类固醇和杜比单抗联合使用,作为一种治疗方案,以应对单用杜比单抗引起的嗜酸性粒细胞肺炎副作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Co-Treatment with Steroid and Dupilumab for Eosinophilic Chronic Rhinosinusitis after Eosinophilic Pneumonitis Caused by Dupilumab.

Eosinophilic chronic rhinosinusitis (ECRS) is a Type 2 inflammatory disease that manifests as chronic inflammation of the paranasal sinus. IL-4/IL-13 receptor monoclonal antibodies (dupilumab) to suppress Type 2 inflammation have become a good treatment option for patients who are refractory to surgery. Most patients respond normally, although significant side effects such as eosinophilic pneumonia may occur, requiring discontinuation of dupilumab. Here, we present a case in which dupilumab administration caused a side-effect of eosinophilic pneumonia. A 65-year-old woman presented with nasal obstruction and olfactory dysfunction due to a nasal polyp. Her symptoms temporarily improved with dupilumab; however, dupilumab was discontinued due to eosinophilic pneumonia. Discontinuation of dupilumab resulted in the rapid resolution of eosinophilic pneumonia and reappearance of nasal polyps. We, therefore, resumed dupilumab treatment in combination with low-dose steroids; eosinophilic pneumonia did not flare up, and the nasal polyps shrank steadily. There is no established treatment strategy in cases where a side effect of eosinophilic pneumonia arises while treating ECRS with dupilumab. Based on the described case, we recommend that a combination of a low-dose steroids and dupilumab be considered as a treatment option to counter the side-effect of eosinophilic pneumonia induced by dupilumab alone.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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