Case Report: Dual monoclonal antibody therapy in chronic rhinosinusitis with nasal polyps and severe eosinophilic asthma-a proteome analysis

Manon Blauwblomme, Philippe Gevaert, Sharon Van Nevel, Sebastian Riemann, Elke Vandewalle, Gabriele Holtappels, Natalie De Ruyck, Lara Derycke, Anne-Sophie Eeckels, Stijn Vanhee, Bart N. Lambrecht, Guy Brusselle, Thibaut Van Zele*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Context: Recent insights into type 2 inflammation have led to the development of monoclonal antibody therapies for severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). Despite add-on therapy with a monoclonal antibody, some individuals remain uncontrolled in terms of upper and/or lower airway symptoms, prompting an exploration of the efficacy of combining biological therapies and their impact on inflammatory pathways. Objectives: In this article, we present a distinctive case of a patient with CRSwNP, severe eosinophilic asthma, and uncontrolled upper airway symptoms, who experienced substantial clinical and local inflammatory improvements through dual monoclonal antibody therapy. Methods: We provide a detailed case description and analysis of the patient's nasal tissue and secretions to gain insights into the local nasal inflammation under this unique therapeutic approach. Results: The addition of an anti-IL-4Rα antibody led to an improvement in upper airway symptoms and a reduction in both eosinophilic and neutrophilic inflammation, despite prior anti-IL-5 therapy. These effects were consistently observed in both polyp tissue and nasal secretions. Conclusion: Our patient, with CRSwNP, severe eosinophilic asthma, and uncontrolled upper airway symptoms, experienced substantial improvement with dual monoclonal antibody therapy, without major complications or side effects.

Original languageEnglish
Article number1484931
Number of pages7
JournalFrontiers in Allergy
Volume5
DOIs
Publication statusPublished - 1 Nov 2024

Bibliographical note

Publisher Copyright:
2024 Blauwblomme, Gevaert, Van Nevel, Riemann, Vandewalle, Holtappels, De Ruyck, Derycke, Eeckels, Vanhee, Lambrecht, Brusselle and Van Zele.

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