Serum and urine eosinophil-derived neurotoxin (EDN) levels predict biologic response in severe asthma

Yu Ri Kang, MD; Hyunkyoung Kim, MS, MPH; Chae Eun Lee, BS; Jae-Woo Jung, MD, PhD; Ji-Yong Moon, MD, PhD; So Young Park, MD, MS; Sae-Hoon Kim, MD, PhD; Min-Suk Yang, MD, PhD; Byung Keun Kim, MD, PhD; Jae-Woo Kwon, MD, PhD; Hye-Kyung Park, MD, PhD; Young-Hee Nam, MD, PhD; Young-Joo Cho, MD, PhD; Taehoon Lee, MD, PhD; Ian M. Adcock, MD, PhD; Pank Bhavsar, MD, PhD; Kian Fan Chung, MD, PhD; Tae-Bum Kim, MD, PhD

World Allergy Organization Journal (Jan 2025)

Serum and urine eosinophil-derived neurotoxin (EDN) levels predict biologic response in severe asthma

Yu Ri Kang, MD,
Hyunkyoung Kim, MS, MPH,
Chae Eun Lee, BS,
Jae-Woo Jung, MD, PhD,
Ji-Yong Moon, MD, PhD,
So Young Park, MD, MS,
Sae-Hoon Kim, MD, PhD,
Min-Suk Yang, MD, PhD,
Byung Keun Kim, MD, PhD,
Jae-Woo Kwon, MD, PhD,
Hye-Kyung Park, MD, PhD,
Young-Hee Nam, MD, PhD,
Young-Joo Cho, MD, PhD,
Taehoon Lee, MD, PhD,
Ian M. Adcock, MD, PhD,
Pank Bhavsar, MD, PhD,
Kian Fan Chung, MD, PhD,
Tae-Bum Kim, MD, PhD

Affiliations

Yu Ri Kang, MD: Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
Hyunkyoung Kim, MS, MPH: Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Chae Eun Lee, BS: Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jae-Woo Jung, MD, PhD: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
Ji-Yong Moon, MD, PhD: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
So Young Park, MD, MS: Department of Internal Medicine, Eulji University School of Medicine, Seoul, South Korea
Sae-Hoon Kim, MD, PhD: Department of Internal Medicine, Division of Allergy and Clinical Immunology, Seoul National University Bundang Hospital, Seongnam, South Korea
Min-Suk Yang, MD, PhD: Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
Byung Keun Kim, MD, PhD: Department of Internal Medicine, Korea University Medical Center Anam Hospital, Seoul, South Korea
Jae-Woo Kwon, MD, PhD: Department of Allergy and Clinical Immunology, Kangwon National University School of Medicine, Chuncheon, South Korea
Hye-Kyung Park, MD, PhD: Department of Internal Medicine, Pusan National University Hospital, Pusan National University College of Medicine, Busan, South Korea
Young-Hee Nam, MD, PhD: Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
Young-Joo Cho, MD, PhD: Department of Allergy and Clinical Immunology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, South Korea
Taehoon Lee, MD, PhD: Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
Ian M. Adcock, MD, PhD: National Heart and Lung Institute, London, UK
Pank Bhavsar, MD, PhD: National Heart and Lung Institute, London, UK
Kian Fan Chung, MD, PhD: National Heart and Lung Institute, London, UK
Tae-Bum Kim, MD, PhD: Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Corresponding author. Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.

Journal volume & issue: Vol. 18, no. 1
p. 100990

Abstract

Read online

Background: Eosinophils are crucial in allergic inflammation, and their correlation with asthma severity has made them a focal point in predicting treatment outcomes. Blood eosinophil count is a commonly utilized marker. However, its limitations have prompted alternative biomarker exploration, such as eosinophil-derived neurotoxin (EDN). Objective: This research was conducted over 24 weeks on 56 patients with severe asthma treated with mepolizumab, reslizumab, and dupilumab. We aimed to evaluate the clinical significance of blood eosinophil count and their potential, including those of blood EDN levels and urine EDN values as biomarkers for predicting treatment response. Methods: The analysis encompassed examining correlations between biomarkers and clinical features, including exacerbation rates and lung function, through ELISA assays and subsequent statistical analyses. The study protocol is registered at ClinicalTrials.gov (NCT05164939). Results: The findings underscore strong correlations between serum EDN levels, blood eosinophil counts, and treatment responses, with EDN demonstrating comparable predictive capabilities to blood eosinophil counts to determine treatment responses. Different biologics exhibited varying efficacy regarding baseline eosinophil counts and EDN levels. Conclusions: Blood eosinophil counts and EDN levels show potential as predictive markers for treatment responses in patients with severe asthma undergoing biologic therapies. However, further comprehensive studies are warranted to enhance the reliability and applicability of EDN as an effective asthma treatment biomarker.

Published in World Allergy Organization Journal

ISSN: 1939-4551 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Immunologic diseases. Allergy
Website: https://www.sciencedirect.com/journal/world-allergy-organization-journal

About the journal

Abstract

Keywords