Vasculitis & polymyalgia rheumatica
Serum cytokine profiling identifies distinct immune phenotypes in eosinophilic granulomatosis with polyangiitis: interleukin-25- and interleukin-5-driven eosinophilic subtypes
Authors' conclusion
EGPA exhibits heterogeneous and exploratory immunopathological patterns associated with IL-25 detectability or IL-5-associated eosinophilia. These findings provide novel insights into the pathogenesis of EGPA and highlight the potential of cytokine-based stratification for prospective personalised therapeutic approaches.
Study context
- Population
- Patients with eosinophilic granulomatosis with polyangiitis (EGPA), including treatment-naïve and mepolizumab-treated individuals, compared with patients with active systemic lupus erythematosus (SLE)
- Participants
- 27 vs 26
- Exposure
- Serum cytokines in treatment-naïve patients with EGPA in comparison with systemic lupus erythematosus (SLE)
- EGPAn = 27
- SLEn = 26
- Outcome
- Th2 cytokines, particularly IL-5
Methodological detailslongitudinal assessment before and after initial therapy and during mepolizumab treatment, eosinophil functional assays, quantification of alarmins
- Longitudinal assessment before and after initial therapy and during mepolizumab treatment
- Eosinophil functional assays
- Quantification of alarmins
Main finding
As reported in the abstract
- Higher in EGPA than in SLE
Observational data: associations, not effects.
Further findings
Th1 and Th17 cytokine levels
- Comparable between EGPA and SLE
IL-1 receptor antagonist (IL-1Ra) levels
- Markedly elevated in EGPA, but not in peripheral eosinophils in vitro
IL-1Ra and IL-8 levels · after the initial treatment
- Both decreased after the initial treatment, suggesting their potential as biomarkers of disease activity
Eosinophilic patterns (subgroup analysis)
- Heterogeneous eosinophilic patterns: one associated with IL-25, and the other with IL-5 in the absence of IL-25
- Subgroup analysis
Original publication
Serum cytokine profiling identifies distinct immune phenotypes in eosinophilic granulomatosis with polyangiitis: interleukin-25- and interleukin-5-driven eosinophilic subtypes. Clin Exp Rheumatol. Published 12 December 2025. doi:10.
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