{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:59:31Z","timestamp":1753891171245,"version":"3.41.2"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:00:00Z","timestamp":1749513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Dupilumab is a humanized monoclonal antibody that targets interleukin-4 (IL-4) and IL-13 pathways, commonly used in the treatment of various inflammatory conditions. Despite its therapeutic efficacy, it can also lead to rare adverse reactions, including serum sickness. Studies exploring serum sickness related to dupilumab is sparse. This report presents a case involving a middle-aged woman who developed a series of symptoms after receiving dupilumab for dermatitis, which ultimately resulted in a diagnosis of serum sickness. In this case, the patient with serum sickness exhibited a range of symptoms, including fever, rash, arthralgia, and myalgia, as well as thrombotic events, transient microscopic hematuria, and abnormal signals in the spleen and kidneys. A proteomic analysis of 92 inflammatory factors in the patient\u2019s serum was performed using Olink technology, revealing significant elevations in several cytokines, including IL-8, IL-6, Caspase-8 (CASP-8), IL-22 receptor subunit alpha-1 (IL-22 RA1), IL-5, IL-24, IL-17A, IL-20 receptor subunit alpha (IL-20RA), IL-2 receptor subunit beta (IL-2RB), and IL-10 receptor subunit alpha (IL-10RA) during the course of serum sickness. This report contributes to the existing knowledge by detailing the clinical manifestations and cytokine profile of serum sickness induced by dupilumab and suggests potential immunological mechanisms underlying this rare adverse reaction. The findings underscore the need for awareness of such reactions and provide a foundation for future research into targeted interventions.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1512482","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T05:23:30Z","timestamp":1749533010000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Serum sickness induced by dupilumab\u2014clinical insights and Olinkproteomic analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Hongguo","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian\u2019e","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linhong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wencui","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jumei","family":"Xia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.iac.2017.07.003","article-title":"Monoclonal antibodies hypersensitivity: prevalence and management","volume":"37","author":"Santos","year":"2017","journal-title":"Immunol Allergy Clin North Am"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/falgy.2023.1219735","article-title":"Hypersensitivity reactions to biologics used in the treatment of allergic diseases: clinical features, diagnosis and management","volume":"4","author":"Sitek","year":"2023","journal-title":"Front Allergy"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-30835-7_22","article-title":"Serum sickness","author":"Saad","year":"2016","journal-title":"Allergy Asthma"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2011.01276.x","article-title":"Incidence of immediate hypersensitivity reaction and serum sickness following administration of Crotalidae polyvalent immune Fab antivenom: a meta-analysis","volume":"19","author":"Schaeffer","year":"2012","journal-title":"Acad Emerg Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1314768","article-title":"Dupilumab treatment in adults with moderate-to-severe atopic dermatitis","volume":"371","author":"Beck","year":"2014","journal-title":"N Engl J Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2016.1186641","article-title":"The safety of monoclonal antibodies in asthma","volume":"15","author":"Passalacqua","year":"2016","journal-title":"Expert Opin Drug Saf"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-018-0370-9","article-title":"Dupilumab: A review in moderate-to-severe atopic dermatitis","volume":"19","author":"Frampton","year":"2018","journal-title":"Am J Clin Dermatol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.12.036","article-title":"Nonirritating skin test concentrations and a case of serum sickness to dupilumab","volume":"11","author":"Jung","year":"2023","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.2019.33.issue-8","article-title":"Treatment of atopic dermatitis with dupilumab: experience from a tertiary referral center","volume":"33","author":"Olesen","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2015.04.014","article-title":"Anaphylaxis and serum sickness in patients receiving omalizumab: reviewing the data in light of clinical experience","volume":"115","author":"Harrison","year":"2015","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520910486","article-title":"A possible case of serum sickness after ocrelizumab infusion","volume":"27","author":"Moreira Ferreira","year":"2021","journal-title":"Mult Scler"},{"key":"B12","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1056\/NEJMicm2216266","article-title":"Serum sickness","volume":"389","author":"Shanshal","year":"2023","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1038\/nbt.2113","article-title":"OpenVigil\u2013free eyeballs on AERS pharmacovigilance data","volume":"30","author":"B\u00f6hm","year":"2012","journal-title":"Nat Biotechnol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/RLI.0000000000000585","article-title":"Multiparametric quantitative MRI for the detection of igA nephropathy using tomoelastography, DWI, and BOLD imaging","volume":"54","author":"Lang","year":"2019","journal-title":"Invest Radiol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.02.001","article-title":"Upregulation of IL-6, IL-8 and CCL2 gene expression after acute inflammation: Correlation to clinical pain","volume":"142","author":"Wang","year":"2009","journal-title":"Pain"},{"key":"B16","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/0014-5793(92)80909-Z","article-title":"Interleukin-8, a chemotactic and inflammatory cytokine","volume":"307","author":"Baggiolini","year":"1992","journal-title":"FEBS Lett"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a028456","article-title":"Interleukin (IL-6) immunotherapy","volume":"10","author":"Tanaka","year":"2018","journal-title":"Cold Spring Harb Perspect Biol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"a016295","DOI":"10.1101\/cshperspect.a016295","article-title":"IL-6 in inflammation, immunity, and disease","volume":"6","author":"Tanaka","year":"2014","journal-title":"Cold Spring Harb Perspect Biol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1770-6","article-title":"Caspase-8 is the molecular switch for apoptosis, necroptosis and pyroptosis","volume":"575","author":"Fritsch","year":"2019","journal-title":"Nature"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/cdd.2014.216","article-title":"Old, new and emerging functions of caspases","volume":"22","author":"Shalini","year":"2014","journal-title":"Cell Death Differentiation"},{"key":"B21","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/978-981-13-9367-9_4","article-title":"Interleukin-10 family cytokines immunobiology and structure","volume":"1172","author":"Wei","year":"2019","journal-title":"Adv Exp Med Biol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2008.00706.x","article-title":"Interleukin-10: new perspectives on an old cytokine","volume":"226","author":"Mosser","year":"2008","journal-title":"Immunol Rev"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-018-8702-3","article-title":"The immunologic role of IL-17 in psoriasis and psoriatic arthritis pathogenesis","volume":"55","author":"Blauvelt","year":"2018","journal-title":"Clin Rev Allergy Immunol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2018.02.006","article-title":"IL-17A promotes the formation of deep vein thrombosis in a mouse model","volume":"57","author":"Ding","year":"2018","journal-title":"Int Immunopharmacol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardiores.2004.06.020","article-title":"Inflammation-induced endothelial dysfunction involves reduced nitric oxide bioavailability and increased oxidant stress","volume":"64","author":"Clapp","year":"2004","journal-title":"Cardiovasc Res"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26041708","article-title":"The interplay between immunity, inflammation and endothelial dysfunction","volume":"26","author":"Chee","year":"2025","journal-title":"Int J Mol Sci"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1512482\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T05:23:31Z","timestamp":1749533011000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1512482\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,10]]},"references-count":26,"alternative-id":["10.3389\/fimmu.2025.1512482"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1512482","relation":{},"ISSN":["1664-3224"],"issn-type":[{"type":"electronic","value":"1664-3224"}],"subject":[],"published":{"date-parts":[[2025,6,10]]},"article-number":"1512482"}}