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Explaining arthropathy development through IL-4 and IL-13 blockade

Presented By
Dr Charlie Bridgewood, University of Leeds, UK
PFGC 2021
Evidence has been found of a previously unknown protective role of IL-4/IL-13 in entheseal induction of the IL-23/IL-17 axis. This might explain clinical observations of emerging musculoskeletal entheseal pathology following dupilumab therapy. IL-4 and IL-13 are key cytokines that are involved in typical Th2 diseases such as atopic dermatitis, asthma, and allergy. Thus, according to Dr Charlie Bridgewood (University of Leeds, UK), blocking IL-4 and IL-13 can be an interesting option for treating Th2 disease. “Something very interesting is that dupilumab therapy has been associated early on with paradoxical disease,” Dr Bridgewood said. Numerous patients show not only new onset of psoriasis but also psoriatic arthritis (PsA) and enthesitis. A possible explanation of this phenomenon is the polarisation of one T-cell pathway that might come at the expense of another. If one pathway is blocked T cells might enter opportunistic pathways (see Figure). “Maybe tha...

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