Anti-IL5/IL5R Treatment in COPD: Should We Target Oral Corticosteroid-Dependent Patients?

Introduction: Monoclonal antibodies targeting interleukin 5 (IL5) or its receptor (IL5R) are frequently used in severe asthma, in which they reduce exacerbations rate and oral corticosteroids (OCS) exposure. Anti-IL5/IL5Rs have been studied in patients with chronic obstructive pulmonary disease (COPD) without convincing benefits. However, these therapies have been used in clinical practice in COPD with apparently good results. Purpose: To describe the clinical characteristics and therapeutic response of COPD patients treated with anti-IL5/IL5R in a real-world setting. Patients and Methods: This is a retrospective case series of patients followed at the Quebec Heart and Lung Institute COPD clinic. Men or women, with an established diagnosis of COPD, and treated either with Mepolizumab or Benralizumab were included. Demographics, disease and exacerbation-related data, airway comorbidities, lung function, and inflammatory profile were extracted from patients' hospital files at baseline visit and 12 months post-treatment. Therapeutic response to biologics was assessed by measuring change in annual exacerbation rate and/or OCS daily dose. Results: Seven COPD patients treated with biologics were identified (5M:2F). All were found to be OCSdependent at baseline. Radiological evidence of emphysema was found in all patients. One case was diagnosed with asthma before age 40. Residual eosinophilic inflammation was found in 5/6 patients (blood eosinophils count 237 ± 225×106 cells/L) despite chronic OCS use. After 12 months of anti-IL5 treatment, mean OCS dose dropped from 12.0 ± 7.6 to 2.6 ± 4.3 mg/day, representing a 78% decrease. Annual exacerbations rate was reduced by 88%, from 8.2 ± 3.3 to 1.0 ± 1.2 per year. Conclusion: Chronic OCS use is a common characteristic of patients treated with anti-IL5/IL5R biological therapies in this real-world setting. In this population, it may be effective in decreasing OCS exposure and exacerbation.

Dry vs soaked wood: modulating the volatile extractible fraction of oak wood by heat treatments.

The aim of this study was to analyze the impact of the water content of wood on the concentrations of volatile compounds which can be extracted after heat treatments. Head Space-Solid Phase Micro Extraction Gas Chromatography coupled to Mass Spectrometry (HS-SPME GC-MS) has been used to compare the concentrations of six aroma compounds (vanillin, furfural, eugenol, guaïacol and cis- and trans-whisky lactones) in hydroalcoholic extracts of heated oak wood samples either previously soaked in hot water or not. Except for eugenol, concentrations of extracted aromas appeared to be lower in soaked woods than in dry woods for temperatures up to 200 °C. If a delaying effect of water could explain such overall lower extracted concentrations from soaked woods, a PCA analysis revealed that for the longer duration (25 min of heat treatment), the adsorbed water could promote a higher impact of furfural, eugenol and both whisky lactones on the composition of hydroalcoholic extracts, suggesting that alternative mechanisms of thermal modifications of the wood macromolecular network could exist at high temperatures in presence of adsorbed water.