Omalizumab (anti-IgE) therapy in the asthma–COPD overlap syndrome (ACOS) and its effects on circulating cytokine levels

Abstract

Context: The term “asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome” (ACOS) has been applied to the condition, in which a person has clinical features of both asthma and COPD.

Methods: The patients (N = 10) were presented to our clinic with low lung function, limited reversibility of airway obstruction, hyperinflation, abnormal body composition, dyspnea and episodic wheezing. Based on the clinical and laboratory findings, the patients were diagnosed with ACOS. Patients’ serum IL-2 (sIL-2), sIL-4 sIL-6, sIL-10, sIL-17, sTNF-α and sIFN-γ levels were investigated as an apoptotic marker and a marker for inflammation.

Results: Having undergone omalizumab treatment and a long-term (12 months) later, patients had a decreased IgE, fractional exhaled nitric oxide concentrations (FENO), eosinophil, neutrophils, macrophages, eosinophil cationic peptide (ECP) and sIL-4 levels.

Conclusion: To our knowledge, this is the first documentation of omalizumab use in ACOS. We demonstrated decreased IL-4, allergic pulmonary symptoms (dyspnea, wheezing, bronchial hyper responsiveness) and migraine attacks in the patients.

Keywords:

• Anti-IgE
• asthma–COPD overlap syndrome
• migraine attacks
• omalizumab
• serum IL-2 (sIL-2)
• sIL-4
• sIL-6
• sIL-10
• sIL-17
• sIFN-γ
• sTNF-α

Acknowledgments

The authors thank patients.

Disclosure statement

The authors declare that they have no conflict of interest.