Significant production of serum and mucosal anti-spike-IgA antibodies after vaccine-encoded or SARS-CoV-2-infection-induced spike-exposures in patients with asthma treated with monoclonal antibodies compared to conventional therapy
Introduction: It has been proposed that patients with asthma on monoclonal antibodies (mAb) targeting Interleukin-5 (IL-5), IL-4/IL-13 pathways or IgE may demonstrate insufficient defense against viral infections requiring strong T-helper-cell-type-1-(Th1) for neutralizing antibody production and cy...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
24 Feb 2026
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| In: |
Journal of asthma and allergy
Year: 2026, Volume: 19, Pages: 1-15 |
| ISSN: | 1178-6965 |
| DOI: | 10.2147/JAA.S547038 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.2147/JAA.S547038 Verlag, kostenfrei, Volltext: https://www.webofscience.com/api/gateway?GWVersion=2&SrcAuth=GetFTR&SrcApp=WOS&DestURL=https%3A%2F%2Fct.prod.getft.io%2FY2xhcml2YXRlLHRhbmRmLE1UQXVNakUwTnk5cVlXRXVjelUwTnpBek9BLE1XSmtORGN4TXpZdFlUUTJOeTAwWW1ReUxXSmxOemN0TURZd1ptRmtOemRqTURCaSxodHRwczovL3d3dy50YW5kZm9ubGluZS5jb20vZG9pL2VwZGYvMTAuMjE0Ny9KQUEuUzU0NzAzOD9zcmM9Z2V0ZnRy.jpMNbw7mWmSat1Ev0J-Ow3JrACq1Z0OnQitUJaG1ZEM&DestApp=GetFTR&SrcItemId=WOS:001699368400001&SrcAppSID=EUW1ED0C4EzHuWfsw85RX6ZOo0RF1&HMAC=T%2FNorgqVQeFycjYgMXuoaJBEuktOFYz7qzaofG3frMQ%3D 
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| Author Notes: | Giovanni Almanzar, Anna Broderdorp, Juliane Mees, Manfred Frey, Felix J.F. Herth, Marc A. Schneider, Frederik Trinkmann, Martina Prelog |
| Summary: | Introduction: It has been proposed that patients with asthma on monoclonal antibodies (mAb) targeting Interleukin-5 (IL-5), IL-4/IL-13 pathways or IgE may demonstrate insufficient defense against viral infections requiring strong T-helper-cell-type-1-(Th1) for neutralizing antibody production and cytotoxic CD8+ T-cell responses for efficient clearance of the viral pathogens. It is a matter of debate whether those mAb may impair the immune response against SARS-CoV-2-spike-protein by interacting with cytokines critical for B-cell differentiation and antibody maturation. This controlled cross-sectional cohort study aimed to characterize the mucosal and serum humoral immune response as well as the cellular reactivity against spike-protein in asthma patients on mAb or on conventional treatment (conv). Materials and Methods: Nasal and serum anti-spike-IgG and-IgA concentrations, avidity, neutralizing IgG and cytokine profiles were assessed using serological and neutralization assays and bead-based cytokine detection in nine patients on mAb matched to nine patients on conv who had received COVID-19-mRNA-vaccination. Proportions of spike-induced subpopulations of T-and B-cells were investigated by flow cytometry. Results: Blockade of IL-5 and IL-5 receptor showed higher serum and nasal concentrations of anti-spike-IgA against recombinantbinding-domain-(RBD) and spike-protein-1-(S1) and similar concentrations of anti-spike-IgG compared to mAb or conv therapy. A spike-specific CD8+ T-cell-driven immune response with increased cytotoxic markers was seen in anti-IL-5 treatments. Baseline Th1 responses correlated with IFN gamma- and TNF alpha-production in supernatants of spike-protein-stimulated cultures in all patients. Conclusion: The findings indicate a significant specific adaptive immune response to SARS-CoV-2-spike-protein exposures by Th1-and Th2-driven responses with a significant response by serum and mucosal anti-S1 and anti-RBD-IgA in anti-IL-5-treated patients compared to IL-4/IL-13-targeting, anti-IgE or conventional therapies. Thus, based on the results it may be expected that immunogenicity of COVID-19-mRNA-vaccines or infection-induced spike-exposures is equivalent between asthma patients on monoclonal antibodies compared to those treated with conventional therapy. |
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| Item Description: | Gesehen am 17.03.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1178-6965 |
| DOI: | 10.2147/JAA.S547038 |