Anti-CCL17 monoclonal antibody, clone 65037

Nonepisodic angioedema with eosinophilia (NEAE) is a rare allergic disease with a young Japanese and East Asian female predominance. NEAE features transient, nonrecurrent angioedema and peripheral blood eosinophilia without visceral organ involvement. Angioedema in NEAE occurs on the extremities, while the trunk and face are rarely involved. Here, we report a case of NEAE affecting only the face in an 80-year-old Japanese man. He was otherwise healthy and took no medication until the sudden development of angioedema on the face. The extremities and trunk were not involved. Skin biopsy examination revealed eosinophilic infiltration and degranulation between collagen bundles through the entire dermis, and perivascular and perifollicular infiltration of eosinophils and lymphocytes, but no evidence of vasculitis. Peripheral hypereosinophilia and high serum thymus-and activation-regulated chemokine (TARC) level were noted. Visceral organ involvement, parasite infection, and an allergic response were not detected in the patient. Administration of oral corticosteroid improved his symptoms rapidly and dramatically with improvements in the blood eosinophil count and serum TARC level. After the corticosteroid was discontinued, no recurrence was observed for 3 years. Thus, he was diagnosed as having NEAE. It should be noted that angioedema with eosinophilia might occur with an unusual presentation and might develop in elderly patients. (c) 2017 The Author(s) Published by S. Karger AG, Basel

Background: Atopic dermatitis (AD) is associated with increased systemic inflammation and cardiovascular risk. Although previous studies have found increased inflammatory proteins in the blood of patients with AD, detailed comparison among patients with AD of different ages is unavailable. Objective: To characterize the blood proteomic signature of patients with AD as a function of age. Methods: We used the OLINK high-throughput proteomic assay to measure serum inflammatory and cardiovascular risk proteins in 71 patients with moderate to severe AD from 3 age groups (18-40 years old [n = 26], 41-60 years old [n = 24], and >60 years old [n = 21]) compared with 37 age-matched controls. Total and allergen-specific serum IgEs were also measured. Results: When we compared patients with AD from 3 different age groups with their respective controls, we identified a total of 172 differentially expressed proteins. T(H)2 chemokines (CCL13, CCL17) were consistently elevated in patients with AD across all ages (P < .05), whereas T(H)1 (CXCL10) and T(H)17 (KYNU, CCL20) markers incrementally increased with age in both patients with AD and healthy subjects. Elderly patients with AD (>60 years old) exhibited striking upregulation of key proinflammatory proteins, including markers of atherosclerosis (CCL4, CCL7, SORT1), cardiovascular risk (GDF15, MPO, ST2), cell adhesion (CDH3), and apoptosis (FAS; all P < .05) compared with younger patients with AD and age-matched controls. We also found that total and allergen-specific serum IgEs decreased significantly with age in patients with AD (P < .05). Conclusion: Elderly patients with AD had increased levels of systemic inflammatory markers, including those associated with cardiovascular and atherosclerosis risk, which may explain their increased incidence of cardiovascular disease. This finding suggests that older patients with AD may benefit from cardiovascular disease screening and prevention. (C) 2019 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.