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CASE REPORT article

Front. Allergy
Sec. Rhinology
Volume 5 - 2024 | doi: 10.3389/falgy.2024.1484931
This article is part of the Research Topic Recent Advances in Rhinology 2024 View all articles

Case Report: Dual Monoclonal Antibody Therapy in Chronic Rhinosinusitis with Nasal Polyps and Severe Eosinophilic Asthma-A Proteome Analysis

Provisionally accepted
Manon Blauwblomme Manon Blauwblomme 1,2,3*Philippe Gevaert Philippe Gevaert 1,2,3Sharon Van Nevel Sharon Van Nevel 2Sebastian Riemann Sebastian Riemann 4Elke Vandewalle Elke Vandewalle 1,2,3Gabriele Holtappels Gabriele Holtappels 2Natalie De Ruyck Natalie De Ruyck 2Lara Derycke Lara Derycke 1,2Anne-Sophie Eeckels Anne-Sophie Eeckels 1,2,3Stijn Vanhee Stijn Vanhee 3Bart Lambrecht Bart Lambrecht 4,5Guy Brusselle Guy Brusselle 4Thibaut Van Zele Thibaut Van Zele 1,2,3*
  • 1 Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium, Ghent, Belgium
  • 2 Upper Airways Research Laboratory, Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
  • 3 Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
  • 4 Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium, Ghent, Belgium
  • 5 Laboratory of immunoregulation and mucosal immunology, VIB Center for Inflammation Research, Ghent, Belgium, Ghent, Belgium

The final, formatted version of the article will be published soon.

    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.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.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.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.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.

    Keywords: Chronic rhinosinusitis with nasal polyposis (CRS wNP), severe eosinophilic asthma, Mepolizumab, Dupilumab, Dual monoclonal antibody therapy, Proteomic analysis

    Received: 22 Aug 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Blauwblomme, Gevaert, Van Nevel, Riemann, Vandewalle, Holtappels, De Ruyck, Derycke, Eeckels, Vanhee, Lambrecht, Brusselle and Van Zele. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Manon Blauwblomme, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium, Ghent, Belgium
    Thibaut Van Zele, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium, Ghent, Belgium

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.