Interleukin (IL)-5 plays a central role in the development and maintenance of eosinophilia and eosinophil activation in a wide variety of eosinophilic disorders. Although IL-5, IL-3 and GM-CSF can modulate expression of IL-5 receptor α (IL-5Rα) on eosinophils in vitro, little is known about soluble and surface IL-5Rα levels in vivo.
To assess surface and soluble IL-5Rα levels in patients with eosinophilia and/or mastocytosis.
Surface IL-5Rα expression was assessed by flow cytometry in blood and/or bone marrow from subjects with eosinophilia (n=39), systemic mastocytosis (n=8) and normal volunteers (n=28). Soluble IL-5Rα (sIL-5Rα) was measured in a cohort of 177 untreated subjects and correlated with eosinophilia, eosinophil activation, serum tryptase and cytokine levels.
Whereas IL-5Rα expression on eosinophils inversely correlated with eosinophilia (r=−0.48, p<0.0001), serum levels of sIL-5Rα increased with eosinophil count (r=0.56, p<0.0001), serum IL-5 (r=0.40, p<0.0001) and IL-13 levels (r=0.29, p=0.004). Of interest, sIL-5Rα was significantly elevated in patients with systemic mastocytosis without eosinophilia. Although sIL-5Rα levels correlated with serum tryptase levels in these patients, eosinophil activation, assessed by CD69 expression on eosinophils and serum eosinophil-derived neurotoxin levels, was increased compared to normal subjects.
These data are consistent with an in vivo IL-5Rα regulatory pathway in human eosinophils similar to that described in vitro and involving a balance between surface and soluble receptor levels. This may have implications with respect to the use of novel therapeutic agents targeting IL-5 and its receptor in patients with eosinophilia and/or mastocytosis.