title: Mepolizumab in the management of severe eosinophilic asthma in adults: current evidence and practical experience.
abstract: Eosinophils represent approximately 1% of peripheral blood leukocytes in normal donors and their maturation and differentiation in the bone marrow are mainly regulated by interleukin (IL)-5 [Broughton et al. 2015]. IL-5, a cytokine that belongs to the β common-chain family, together with IL-3 and granulocyte-macrophage colony-stimulating factor (GM-CSF), stimulates also the activation and survival of eosinophils and, to some extent, of basophils. IL-5 binds to a heterodimer receptor composed of the specific subunit IL-5Rα and a common subunit βc shared with IL-3 and GM-CSF. Human eosinophils express approximately a three-fold higher level of IL-5Rα compared with basophils. Major sources of IL-5 are T-helper 2 (Th2) cells, mast cells, CD34+ progenitor cells, invariant natural killer (NK) T-cells, group 2 innate lymphoid cells (ILC2s), and eosinophils themselves. ILC2s control not only eosinophil number but also their circadian cycling through the production of IL-5.
authors.affiliation: Department of Translational Medical Sciences, Division of Clinical Immunology and Allergy, University of Naples Federico II, Naples, Italy.
authors.forename: Gilda
authors.initials: G
authors.lastname: Varricchi
authors.affiliation: Allergy & Respiratory Diseases Clinic-DIMI-University of Genova, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Bagnasco
authors.affiliation: Allergy & Respiratory Diseases Clinic-DIMI-University of Genova, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferrando
authors.affiliation: Department of Internal Medicine, Respiratory Disease Clinic, IRCCS Humanitas Clinical and Research Center, Humanitas University, Rozzano- Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Puggioni
authors.affiliation: Allergy & Respiratory Diseases Clinic-DIMI-University of Genova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Passalacqua
authors.affiliation: Allergy & Respiratory Disease Clinic, DIMI Department of Internal Medicine IRCCS AOU, San Martino-IST University of Genoa, Genova, Italy.
authors.forename: Giorgio W
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology; D004802:Eosinophilia / Q000188:drug therapy* / Q000276:immunology; D004804:Eosinophils / Q000276:immunology; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000378:metabolism; D006801:Humans; D007377:Interleukin-3 / Q000276:immunology; D015848:Interleukin-5 / Q000276:immunology; D053649:Receptors, Interleukin-5 / Q000276:immunology; D012720:Severity of Illness Index
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007377:Interleukin-3; D015848:Interleukin-5; D053649:Receptors, Interleukin-5; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; C434107:mepolizumab
keywords: IL-5; asthma; eosinophilia; exacerbations; mepolizumab; personalized medicine; severe asthma; targeted therapy