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The alarmin(g) effect of interleukin-5 blockade on residual eosinophil function is of clinical consequence

Congratulations to Van Hulst et al. [1] regarding their article on the influence of interleukin (IL)-5 blockade on blood eosinophils in severe asthma. In their discussion, the authors state that it is unclear whether increased stimulation-induced expression of suppressor of cytokine signalling-3 (SOCS3) in eosinophils in IL-5-depleted conditions is of clinical consequence. However, their data can be linked to that of Seki et al. [2] and McDowell et al. [3] to speculate that the signal for stronger IL-33-mediated induction of SOCS3 becomes clinically relevant at the time of a mepolizumab-emergent asthma attack. Van Hulst and co-workers report stronger SOCS3 induction in blood eosinophils from mepolizumab-treated patients stimulated ex vivo with IL-33. The clinical significance is yet unknown, but it may explain some eosinophilic asthma attacks under mepolizumab. https://bit.ly/3yqp4If