Diagnostic value of blood inflammatory and oxidative stress markers in severe allergic eosinophilic asthma patients undergoing anti-IL-5 therapy

<bold>Introduction</bold>. Monoclonal anti-interleukin (IL)-5 medications are effective in treating patients with severe allergic eosinophilic asthma (SEA); however, not all the them experience the appropriate responses. We hypothesize that blood markers indicating ongoing inflammation and oxidative stress could help predict and diagnose the effectiveness of biological therapy to SEA patients <bold>The aim</bold>. To investigate the diagnostic value of circulating interleukin (IL) 33, 4, 13, 25, thymic stromal lymphopoietin (TSLP), high-affinity IgE receptor (FCεRI), tyrosine-protein kinase Met (MET), pentraxin 3 (PTX-3), thioredoxin 1 (TRX1) in SEA patients after anti-IL-5 treatment <bold>Methods</bold>. We included 10 SEA patients who received mepolizumab and collected their serum samples before (V1), 1 month (V2), 3 months (V3) and 6 months (V4) after prescribing medication. Blood levels of analytes were measured by using enzyme-linked immunosorbent assay <bold>Results</bold>. TSLP levels dropped at V2 but later enhanced, showing no long-term difference. MET and eotaxin levels significantly increased and remained so whole period, p<0.05. IL-33 levels enhanced, whereas IL-4 and FCεRI decreased, with the greatest changes seen at V4. IL-13 levels decreased consistently, while IL-25 levels were unaffected by anti-IL-5 therapy. Oxidative stress marker TRX1 levels did not change at V2 but increased at V3 and V4, while PTX3 levels significantly decreased at V2, returned to baseline at V3, and significantly enhanced at V4, compared to V1, p<0.05 <bold>Conclusion</bold>. Biological therapy targeting IL-5 in SEA patients significantly modulates the blood levels of chronic inflammation and oxidative stress markers, with complex temporal dynamics post-treatment, indicating their prognostic and diagnostic value