Similarly in a

short-term clinical study, treatment of patients with severe persistent asthma with the monoclonal antibody Mepolizumab BKM120 showed a dramatic depletion of blood eosinophils but no appreciable effect on bronchial mucosal staining of eosinophil major basic protein [44] and [45]. Other clinical studies have not demonstrated appreciable effects on late asthmatic reactions, airway hyper-responsiveness or other clinical outcomes including lung function but indirect evidence for an effect on airway remodelling has been reported. Interestingly, blocking IL-5 resulted in reduced airway remodelling in mice [46], a finding consistent with the observation in mice that selective removal of eosinophils by genetic Doxorubicin nmr means also resulted in reduced fibrosis of the lung [47] and [48]. Recent clinical data has shown that in refractory

eosinophilic asthma and prednisone dependent asthma, Mepolizumab not only decreased eosinophils in blood and sputum eosinophils but also decreased the number of asthma exacerbations [18] and [19]. Our studies showed that although eosinophils in BAL were largely reduced in Qβ-IL-5 vaccinated mice which were then sensitized and challenged with OVA, some eosinophils were still present in lung tissues. This result was not completely unexpected, since eosinophils may also be recruited by chemokines like eotaxin. Vaccination with Qβ-Eot alone also resulted in a reduction of eosinophils in the airways of OVA sensitized and challenged mice, even though the effect was less pronounced than in Qβ-IL-5 vaccinated mice. As a caveat, it should be noted that, in order to establish effective neutralizing titers, Qβ-IL-5 and Qβ-Eot vaccines were administered prior to OVA sensitization. Such prophylactic use of the vaccines was

necessary due to the limited time-span between the sensitization and challenge phases employed in the model. Hence it is possible that a reduction of eosinophils may have interfered Resminostat with the induction of the allergic response prior to sensitization which could have inhibited the effector phase during the challenge [9]. However it has been shown in murine and guinea pig models of allergic asthma that administering neutralizing anti-IL-5 monoclonal antibodies after antigen sensitization reduces lung eosinophilia [49] and [50]. It is also likely that if vaccination could be employed therapeutically in these models it would have a similar effect. One approach to developing effective vaccines which may ameliorate the disease symptoms would be to target both molecules simultaneously. We therefore targeted eotaxin in addition to IL-5. As expected, there was only minimal number of eosinophils in BAL of mice immunized with both Qβ-IL-5 and Qβ-Eot.