Details

Autor(en) / Beteiligte

• Betancor, Diana
• Valverde-Monge, Marcela
• Sastre, Joaquin

Titel

Upadacitinib-induced remission of allergic asthma: A case report

Ist Teil von

• The journal of allergy and clinical immunology in practice (Cambridge, MA), 2021-11, Vol.9 (11), p.4162-4163

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Upadacitinib is an oral, reversible, selective Janus kinase (JAK) inhibitor that has demonstrated higher selectivity for JAK1 compared with JAK2, JAK3, and tyrosine kinase in cellular assays.1 JAK1 has an essential role in the expression of IL-4, IL-5, IL-13, and IL-31, all of which are associated with proinflammatory signaling pathways in atopic dermatitis (AD).2 In 2019, the US Food and Drug Administration and European Medicines Agency approved the use of upadacitinib in adult patients with moderate to severe rheumatoid arthritis refractory to biologic disease-modifying antirheumatic drugs. Results of phase III clinical studies of upadacitinib in patients with moderate to severe AD refractory to topical treatment have been highly promising.3 Allergic asthma is characterized by airway inflammation resulting from the generation of key cytokines (IL-4, IL-5, and IL-13) released by TH2 cells upon activation of IL-13–dependent genes.4 Therefore, inhibition of these pathways is likely to reduce the activation of TH2 cells, improving asthma symptoms and promoting asthma control. A study by Ashino et al5 demonstrated this inhibiting effect in vitro and showed the prevention of airway hyperresponsiveness and TH2 cytokine production through an in vivo animal model with allergen challenges.5 We present a 45-year-old male nonsmoker with a history of atopy since childhood consistent with mild AD, seasonal rhinoconjunctivitis, and mild to well–controlled asthma with multiple sensitizations to aeroallergens (pollen, dust mites, mold, and pet dander).