IL-4 receptor blockade is a global repressor of naïve B cell development and responses in a dupilumab-treated patient.

Here, we report a case of atopic dermatitis (AD) in a patient who received biweekly doses of dupilumab, an antibody against the IL-4 receptor α chain (IL-4Rα). Single cell RNA-sequencing showed that naïve B cells expressed the highest levels of IL4R compared to other B cell subpopulations. Compared to controls, the dupilumab-treated patient exhibited diminished percentages of IL4R+IGHD+ naïve B cells and down-regulation of IL4R, FCER2 (CD23), and IGHD. Dupilumab treatment resulted in upregulation of genes associated with apoptosis and inhibition of B cell receptor signaling and down-regulation of class-switch and memory B cell development genes. The dupilumab-treated patient exhibited a rapid decline in COVID-19 anti-spike and anti-receptor binding domain antibodies between 4 and 8 and 11 months post COVID-19 vaccination. Our data suggest that intact and persistent IL-4 signaling is necessary for maintaining robust survival and development of naïve B cells, and maintaining a long term vaccine response.

Evaluation of adult patients with atopic dermatitis treated with dupilumab: A single-center real-life experience.

BACKGROUND: Adult atopic dermatitis (AD), especially adult-onset type appears to have different clinical manifestations. Dupilumab is an IL-4 receptor antagonist used in patients with moderate and severe atopic dermatitis, aged 12 years and older and it works by inhibiting the IL-4 and IL-13 signaling pathway. The purpose of our study is to retrospectively investigate the side effect profile and drug efficacy of thirteen adult patients who received dupilumab treatment and to evaluate the drug use status and the results during the COVID-19 pandemicour stuAdult atopic dermatitis (AD), especially adult-onset type appears to have different clinical manifestations. Dupilumab is an IL-4 receptor antagonist used in patients with moderate and severe atopic dermatitis, aged 12 years and older and it works by inhibiting the IL-4 and IL-13 signaling pathway. The purpose of our study is to retrospectively investigate the side effect profile and drug efficacy of thirteen adult patients who received dupilumab treatment and to evaluate the drug use status and the results during the COVID-19 pandemicAdult atopic dermatitis (AD), especially adult-onset type appears to have different clinical manifestations. Dupilumab is an IL-4 receptor antagonist used in patients with moderate and severe atopic dermatitis, aged 12 years and older and it works by inhibiting the IL-4 and IL-13 signaling pathway. The purpose of dy is to retrospectively investigate the side effect profile and drug efficacy of thirteen adult patients who received dupilumab treatment and to evaluate the drug use status and the results during the COVID-19 pandemicAdult atopic dermatitis (AD), especially adult-onset type appears to have different clinical manifestations. Dupilumab is an IL-4 receptor antagonist used in patients with moderate and severe atopic dermatitis, aged 12 years and older and it works by inhibiting the IL-4 and IL-13 signaling pathway. The purpose of our study is to retrospectively investigate the side effect profile and drug efficacy of thirteen adult patients who received dupilumab treatment and to evaluate the drug use status and the results during the COVID-19 pandemic. MATERIALS AND METHODS: Thirteen patients with clinical and/or histopathological diagnoses of atopic dermatitis who received dupilumab treatment and were subsequently followed up in Bezmialem Vakif University dermatology outpatient clinic between April 2019 and October 2021 were included in our study.Patient files were reviewed, and patients were interviewed in-person or by phone to learn about the COVID-19 contagion.Descriptive statistical analysis was performed with Microsoft Excel, and the data obtained were calculated as mean and percentage. RESULTS: All of our patients responded to the treatment after one course of dupilumab injection and also CRP and LDH levels decreased. Conjunctivitis side effect was found at a slightly higher rate than in previous clinical studies. The treatment was continued during the COVID-19 pandemic in most patients. Meanwhile, four patients had COVID-19 infection, but one of them was not using dupixent at that time. CONCLUSION: We can conclude that dupilumab is an effective and safe therapy for patients with severe AD also in cases of severe infections.