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Akenroye A, Nopsopon T, Cho L, Moll M, Weiss ST. Lower myostatin and higher MUC1 levels are associated with better response to mepolizumab and omalizumab in asthma: a protein-protein interaction analyses. Respir Res 2023; 24:305. [PMID: 38057814 PMCID: PMC10698971 DOI: 10.1186/s12931-023-02620-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION Biomarkers are needed to inform the choice of biologic therapy in patients with asthma given the increasing number of biologics. We aimed to identify proteins associated with response to omalizumab and mepolizumab. METHODS Aptamer-based proteomic profiling (SomaScan) was used to assess 1437 proteins from 51 patients with moderate to severe asthma who received omalizumab (n = 29) or mepolizumab (n = 22). Response was defined as the change in asthma-related exacerbations in the 12 months following therapy initiation. All models were adjusted for age, sex, and pre-treatment exacerbation rate. Additionally, body mass index was included in the omalizumab model and eosinophil count in the mepolizumab model. We evaluated the association between molecular signatures and response using negative binomial regression correcting for the false discovery rate (FDR) and gene set enrichment analyses (GSEA) to identify associated pathways. RESULTS Over two-thirds of patients were female. The average age for omalizumab patients was 42 years and 57 years for mepolizumab. At baseline, the average exacerbation rate was 1.5/year for omalizumab and 2.4/year for mepolizumab. Lower levels of LOXL2 (unadjusted p: 1.93 × 10E-05, FDR-corrected: 0.028) and myostatin (unadjusted: 3.87 × 10E-05, FDR-corrected: 0.028) were associated with better response to mepolizumab. Higher levels of CD9 antigen (unadjusted: 5.30 × 10E-07, FDR-corrected: 0.0006) and MUC1 (unadjusted: 1.15 × 10E-06, FDR-corrected: 0.0006) were associated with better response to omalizumab, and LTB4R (unadjusted: 1.12 × 10E-06, FDR-corrected: 0.0006) with worse response. Protein-protein interaction network modeling showed an enrichment of the TNF- and NF-kB signaling pathways for patients treated with mepolizumab and multiple pathways involving MAPK, including the FcER1 pathway, for patients treated with omalizumab. CONCLUSIONS This study provides novel fundamental data on proteins associated with response to mepolizumab or omalizumab in severe asthma and warrants further validation as potential biomarkers for therapy selection.
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Affiliation(s)
- Ayobami Akenroye
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA, 02115, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital, 60 Fenwood Road, BostonBoston, MA, 02115, USA.
| | - Tanawin Nopsopon
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Laura Cho
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Matthew Moll
- Channing Division of Network Medicine, Brigham and Women's Hospital, 60 Fenwood Road, BostonBoston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, 60 Fenwood Road, Boston, MA, 02115, USA
| | - Scott T Weiss
- Channing Division of Network Medicine, Brigham and Women's Hospital, 60 Fenwood Road, BostonBoston, MA, 02115, USA
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Porsbjerg CM, Menzies-Gow AN, Tran TN, Murray RB, Unni B, Audrey Ang SL, Alacqua M, Al-Ahmad M, Al-Lehebi R, Altraja A, Belevskiy AS, Björnsdóttir US, Bourdin A, Busby J, Canonica GW, Christoff GC, Cosio BG, Costello RW, FitzGerald JM, Fonseca JA, Hansen S, Heaney LG, Heffler E, Hew M, Iwanaga T, Jackson DJ, Kocks JWH, Kallieri M, Bruce Ko HK, Koh MS, Larenas-Linnemann D, Lehtimäki LA, Loukides S, Lugogo N, Maspero J, Papaioannou AI, Perez-de-Llano L, Pitrez PM, Popov TA, Rasmussen LM, Rhee CK, Sadatsafavi M, Schmid J, Siddiqui S, Taillé C, Taube C, Torres-Duque CA, Ulrik C, Upham JW, Wang E, Wechsler ME, Bulathsinhala L, Carter V, Chaudhry I, Eleangovan N, Hosseini N, Rowlands MA, Price DB, van Boven JFM. Global Variability in Administrative Approval Prescription Criteria for Biologic Therapy in Severe Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:1202-1216.e23. [PMID: 34990866 DOI: 10.1016/j.jaip.2021.12.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/08/2021] [Accepted: 12/05/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Regulatory bodies have approved five biologics for severe asthma. However, regional differences in accessibility may limit the global potential for personalized medicine. OBJECTIVE To compare global differences in ease of access to biologics. METHODS In April 2021, national prescription criteria for omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab were reviewed by severe asthma experts collaborating in the International Severe Asthma Registry. Outcomes (per country, per biologic) were (1) country-specific prescription criteria and (2) development of the Biologic Accessibility Score (BACS). The BACS composite score incorporates 10 prescription criteria, each with a maximum score of 10 points. Referenced to European Medicines Agency marketing authorization specifications, a higher score reflects easier access. RESULTS Biologic prescription criteria differed substantially across 28 countries from five continents. Blood eosinophil count thresholds (usually ≥300 cells/μL) and exacerbations were key requirements for anti-IgE/anti-IL-5/5R prescriptions in around 80% of licensed countries. Most countries (40% for dupilumab to 54% for mepolizumab) require two or more moderate or severe exacerbations, whereas numbers ranged from none to four. Moreover, 0% (for reslizumab) to 21% (for omalizumab) of countries required long-term oral corticosteroid use. The BACS highlighted marked between-country differences in ease of access. For omalizumab, mepolizumab, benralizumab, and dupilumab, only two, one, four, and seven countries, respectively, scored equal or higher than the European Medicines Agency reference BACS. For reslizumab, all countries scored lower. CONCLUSIONS Although some differences were expected in country-specific biologic prescription criteria and ease of access, the substantial differences found in the current study present a challenge to implementing precision medicine across the world.
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Affiliation(s)
- Celeste M Porsbjerg
- Respiratory Research Unit, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark
| | - Andrew N Menzies-Gow
- UK Severe Asthma Network and National Registry, Royal Brompton and Harefield Hospitals, London, United Kingdom
| | | | - Ruth B Murray
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Bindhu Unni
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Shi Ling Audrey Ang
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | | | - Mona Al-Ahmad
- Al-Rashed Allergy Center, Ministry of Health, Microbiology Department, Faculty of Medicine, Kuwait University, Kuwait
| | - Riyad Al-Lehebi
- Department of Pulmonology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Alan Altraja
- Department of Pulmonology, University of Tartu and Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Andrey S Belevskiy
- Department of Pulmonology, N.I. Pirogov Russian State National Research Medical University, Moscow, Russian Federation
| | - Unnur S Björnsdóttir
- Department of Respiratory Medicine and Sleep, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Arnaud Bourdin
- PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France
| | - John Busby
- UK Severe Asthma Network and National Registry, Queen's University Belfast, Belfast, Northern Ireland
| | - G Walter Canonica
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Borja G Cosio
- Son Espases University Hospital-IdISBa-Ciberes, Mallorca, Spain
| | - Richard W Costello
- Clinical Research Centre, Smurfit Building Beaumont Hospital, Department of Respiratory Medicine, RCSI, Dublin, Ireland
| | | | - João A Fonseca
- Health Information and Decision Sciences Department (MEDCIDS) and Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of University of Porto, Porto, Portugal
| | - Susanne Hansen
- Respiratory Research Unit, Copenhagen University Hospital-Bispebjerg, Copenhagen, Denmark; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Liam G Heaney
- Wellcome-Wolfson Centre for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland
| | - Enrico Heffler
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Mark Hew
- Allergy, Asthma, and Clinical Immunology Service, Alfred Health, Melbourne, Victoria, Australia; Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Takashi Iwanaga
- Center for General Medical Education and Clinical Training, Kindai University Hospital, Osakasayama, Japan
| | - Daniel J Jackson
- UK Severe Asthma Network and National Registry, Guy's and St Thomas' NHS Trust, London, United Kingdom; School of Immunology and Microbial Sciences, King's College London, London, United Kingdom
| | - Janwillem W H Kocks
- Observational and Pragmatic Research Institute, Singapore, Singapore; General Practitioners Research Institute, Groningen, The Netherlands; Groningen Research Institute Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maria Kallieri
- Second Respiratory Medicine Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | | | - Mariko Siyue Koh
- Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore; SingHealth Duke-NUS Lung Centre, Duke-NUS Medical School, Singapore
| | - Désirée Larenas-Linnemann
- Directora Centro de Excelencia en Asma y Alergia, Hospital Médica Sur, Ciudad de México, Mexico City, Mexico
| | - Lauri A Lehtimäki
- Allergy Centre, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Stelios Loukides
- Second Respiratory Medicine Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Njira Lugogo
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich
| | - Jorge Maspero
- Clinical Research for Allergy and Respiratory Medicine, CIDEA Foundation, Buenos Aires, Argentina; University Career of Specialists in Allergy and Clinical Immunology at the Buenos Aires University School of Medicine, Buenos Aires, Argentina
| | - Andriana I Papaioannou
- Second Respiratory Medicine Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece
| | - Luis Perez-de-Llano
- Department of Respiratory Medicine, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Paulo Márcio Pitrez
- Hospital Moinhos de Vento, Porto Alegre, Brazil and Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Linda M Rasmussen
- Allergy Clinic, Copenhagen University Hospital-Gentofte, Hellerup, Denmark
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Mohsen Sadatsafavi
- Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Salman Siddiqui
- University of Leicester, Department of Respiratory Sciences and NIHR Leicester Biomedical Research Centre, Leicester, United Kingdom
| | - Camille Taillé
- Department of Respiratory Diseases, Bichat Hospital, AP-HP Nord-Université de Paris, Paris, France
| | - Christian Taube
- Department of Pulmonary Medicine, University Medical Center Essen-Ruhrlandklinik, Essen, Germany
| | | | - Charlotte Ulrik
- Respiratory Research Unit, Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
| | - John W Upham
- Diamantina Institute and PA-Southside Clinical Unit, The University of Queensland, Brisbane, Queensland, Australia
| | - Eileen Wang
- Division of Allergy and Clinical Immunology, Department of Medicine, National Jewish Health, Denver, Colo; Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colo
| | - Michael E Wechsler
- NJH Cohen Family Asthma Institute, Department of Medicine, National Jewish Health, Denver, Colo
| | - Lakmini Bulathsinhala
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Victoria Carter
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Isha Chaudhry
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Neva Eleangovan
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Naeimeh Hosseini
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - Mari-Anne Rowlands
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore
| | - David B Price
- Optimum Patient Care, Cambridge, United Kingdom; Observational and Pragmatic Research Institute, Singapore, Singapore; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
| | - Job F M van Boven
- Department of Clinical Pharmacy and Pharmacology, Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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