Evidence map›Paper›PMID 31657082›Full record

Trial reportClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology2019

Mechanisms of glucocorticoid resistance in hypereosinophilic syndromes.

Kindra Stokes, Pryscilla Yoon, Michelle Makiya, Meheret Gebreegziabher, Nicole Holland-Thomas, JeanAnne Ware, Lauren Wetzler, Paneez Khoury, Amy D Klion

Open access · greenAbstract readClinical Trial
In one paragraph

Trial report in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Kindra StokesLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.ORCID 0000-0002-0768-7541
Pryscilla YoonLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
Michelle MakiyaLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
Meheret GebreegziabherLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
Nicole Holland-ThomasLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
JeanAnne WareLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
Lauren WetzlerLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
Paneez KhouryLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
Amy D KlionLaboratory of Parasitic Diseases, NIAID, National Institutes of Health, Bethesda, Maryland.
National Institutes of Health · US

Funding

Eosinophils and Eosinophil Activation in the Pathogenesis of Human DiseaseZIAAI001130 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI KLION, AMY · 2010 to 2025
$22.5M
Intramural NIH HHS Z99 AI999999Intramural NIH HHS ZIA AI001130
6 · The paper itself

Abstract

backgroundGlucocorticoids (GC) are considered first-line therapy for most patients with hypereosinophilic syndrome (HES). Although response rates are generally high, many patients require moderate to high doses for control of eosinophilia and symptoms, and up to 15% of patients do not respond at all. Despite this, little is known about the mechanisms of GC resistance in patients with HES.

objectiveTo explore the aetiology of GC resistance in HES.

methodsClinical data and samples from 26 patients with HES enrolled on a prospective study of GC responsiveness and 23 patients with HES enrolled on a natural history study of eosinophilia for whom response to GC was known were analysed retrospectively. Expression of GC receptor isoforms was assessed by quantitative RT-PCR in purified eosinophils. Serum cytokine levels were quantified by suspension array assay in multiplex.

resultsDespite an impaired eosinophil response to GC after 7 days of treatment, the expected rise in absolute neutrophil count was seen in 7/7 GC-resistant patients, suggesting that GC resistance in HES is not a global phenomenon. Eosinophil mRNA expression of glucocorticoid receptor (GR) isoforms (α, β, and P) was similar between GC-sensitive (n = 20) and GC-resistant (n = 9) patients with HES. Whereas geometric mean serum levels were also comparable between GC-r (n = 11) and GC-s (n = 19) for all cytokines tested, serum IL-5 levels were >100 pg/mL only in GC-r patients. CONCLUSIONS AND CLINICAL RELEVANCE: These data suggest that the mechanism of GC resistance in HES is not due to a global phenomenon affecting all lineages, but may be due, at least in some patients, to impairment of eosinophil apoptosis by increased levels of IL-5.

Indexed as

AdolescentAdultAgedDrug ResistanceFemaleGene Expression RegulationGlucocorticoidsHumansHypereosinophilic SyndromeInterleukin-5MaleMiddle AgedProspective StudiesProtein IsoformsReceptors, GlucocorticoidGlucocorticoidsIL5 protein, humanInterleukin-5Protein IsoformsReceptors, Glucocorticoideosinophileosinophiliaglucocorticoid receptorsteroid

Identifiers

PMID31657082
PMCPMC6910955
OpenAlexW2982128296

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.