Anti-IL-6 treatment in two pediatric patients with severe persistent asthma with the IL4R 576 variant (original) (raw)

Journal of Allergy and Clinical Immunology

RATIONALE: To find useful biomarkers for a differential diagnosis between asthma and COPD, we evaluated NAGL (neutrophil gelatinaseassociated lipocalin), sRAGE (soluble receptor for advanced glycosylation end products), and anti-elastin antibody. METHODS: The subjects were patients with asthma (10 men, 14 women; mean age, 67.4 years) and COPD (16 men, 0 women; 74.8 years). Samples from sputum and serum were collected, and NAGL, sRAGE, and antielastin antibody levels were measured. RESULTS: Sputum levels of NAGL were significantly higher in COPD (5.91 6 5.75 mg/mL) than asthma (2.41 6 2.91 mg/mL, p<0.05), although serum levels did not differ significantly (69.0 6 19.8 ng/mL and 67.3 6 27.0 ng/mL, respectively). Neither sputum nor serum levels of sRAGE were significantly different between COPD (0.45 6 0.89 ng/mL and 0.40 6 0.18 ng/mL, respectively) and asthma (0.19 6 0.21 ng/mL and 0.51 6 0.20 ng/mL, respectively). However, levels of anti-elastin antibody were significantly higher in asthma than COPD in sputum (11.0 6 7.3 mg/mL and 5.8 6 5.2 mg/mL, respectively; p <0.05) and serum (44.2 6 77.4 and 10.3 6 22.3 mg/mL, respectively; p<0.05). CONCLUSIONS: NAGL in sputum may be a useful biomarker for COPD. Elastin is found throughout the airways. The production of antielastin antibody in asthma may contribute to airway remodeling via autoimmune inflammation, but not to emphysema in COPD. We are currently analyzing these relationships against patient backgrounds and other data. We will present our final results at the 2018 AAAAI/WAO.