Given the role of IL-4 in immunoglobulin class-switching
and germinal center reactions, could IL-4 axis-targeting treatments
cause defective B cell responses against SARS-CoV-2?
IL-4 is pleiotropic and could theoretically cause negative effects on
immune responses. However, based on phase II and III studies with
dupilumab (an IL-4Rα-specific monoclonal antibody that blocks IL-4 and
IL-13 signaling) in the context of atopic dermatitis, chronic
rhinosinusitis with nasal polyps and asthma, no increased risk of
infections to viral or bacterial pathogens have been
documented.44 Furthermore, dupilumab had no impact on
responses to non-live vaccines.45