Eosinophil-Linked Hyperdynamic Circulation in EGPA Improves under Anti-IL-5 Therapy: A Longitudinal Study

Eosinophil-Linked Hyperdynamic Circulation in EGPA Improves under Anti-IL-5 Therapy: A Longitudinal Study | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 25 September 2025 V1 Latest version Share on Eosinophil-Linked Hyperdynamic Circulation in EGPA Improves under Anti-IL-5 Therapy: A Longitudinal Study Authors : PALMA CARLUCCI 0000-0001-7661-0866 , Marialuisa Sveva Marozzi 0000-0001-7832-357X , Francesco Corvasce , Silvia Noviello , Federico Spataro , Vanessa Desantis , Monica Montagnani , Roberto Ria , Sebastiano Cicco 0000-0002-1980-5728 [email protected] , and Angelo Vacca Authors Info & Affiliations https://doi.org/10.22541/au.175880920.07831546/v1 182 views 111 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis characterized by eosinophilic inflammation and potential cardiovascular involvement. While pulmonary hypertension (PH) is uncommon, the relationship between eosinophil burden and subclinical pulmonary vascular dysfunction remains unclear. Methods: We conducted a single-centre longitudinal study of 27 EGPA patients to evaluate the association between peripheral eosinophil counts (PEC) at diagnosis and echocardiographic markers of hyperdynamic circulation and early right ventricular-pulmonary artery (RV-PA) uncoupling. Patients starting anti-IL-5 therapy (mepolizumab/benralizumab) underwent echocardiographic assessments, including pulmonary artery systolic pressure (PAPs), tricuspid annular plane systolic excursion (TAPSE), TAPSE/PAPs ratio, and tricuspid regurgitation velocity (TRV) at three timepoints: baseline (at diagnosis), at therapy initiation (T0), and 24 months after (T24). Patients were stratified by median PEC at diagnosis. Multivariable regression and ROC analysis were used to explore associations and predictive thresholds. Results: At T0, 33% of patients exhibited elevated PAPs (>25 mmHg), without clinical PH. Higher PEC were significantly associated with elevated PAPs levels (p = 0.044) and decreased TAPSE/PAPs ratio (p = 0.037). Longitudinal analysis at baseline and T0 showed significant worsening in PAPs and TRV values, with improvement at T24 after anti-IL-5 therapy (PAPs Δ = −7.1 mmHg, p = 0.001; TRV Δ = −0.35 m/s, p = 0.005; TAPSE/PAPs Δ = +0.41 ± 0.55; p = 0.005). ROC analysis identified an eosinophil threshold of 3,465 cells/μL (AUC = 0.696; sensitivity = 91.7%) as potential predictor of elevated PAPs. Conclusions: Elevated PEC may signal early pulmonary vascular dysfunction and RV–PA uncoupling EGPA, which may be partially reverted with the anti-IL-5 therapy. These findings support the importance of early cardiovascular surveillance in eosinophil-rich EGPA phenotypes. Supplementary Material File (manuscript egpa 16092025_final.docx) Download 1.16 MB Information & Authors Information Version history V1 Version 1 25 September 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords chemokines clinical immunology eosinophils vasculitis Authors Affiliations PALMA CARLUCCI 0000-0001-7661-0866 Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Marialuisa Sveva Marozzi 0000-0001-7832-357X Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Francesco Corvasce Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Silvia Noviello Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Federico Spataro Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Vanessa Desantis Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Monica Montagnani Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Roberto Ria Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Sebastiano Cicco 0000-0002-1980-5728 [email protected] Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Angelo Vacca Universita degli Studi di Bari Aldo Moro Dipartimento di Medicina di Precisione e Rigenerativa e Area Jonica View all articles by this author Metrics & Citations Metrics Article Usage 182 views 111 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation PALMA CARLUCCI, Marialuisa Sveva Marozzi, Francesco Corvasce, et al. Eosinophil-Linked Hyperdynamic Circulation in EGPA Improves under Anti-IL-5 Therapy: A Longitudinal Study. Authorea . 25 September 2025. DOI: https://doi.org/10.22541/au.175880920.07831546/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. Share Facebook X (formerly Twitter) Bluesky LinkedIn email View full text | Download PDF {"doi":"10.22541/au.175880920.07831546/v1","type":"Article"} Now Reading: Share Figures Tables Close figure viewer Back to article Figure title goes here Change zoom level Go to figure location within the article Download figure Toggle share panel Toggle share panel Share Toggle information panel Toggle information panel Go to previous graphic Go to next graphic Go to previous table Go to next table All figures All tables View all material View all material xrefBack.goTo xrefBack.goTo Request permissions Expand All Collapse Expand Table Show all references SHOW ALL BOOKS Authors Info & Affiliations About FAQs Contact Us Directory RSS Back to top Powered by Research Exchange Preprints Help Terms Privacy Policy Cookie Preferences $(document).ready(() => setTimeout(() => { let _bnw=window,_bna=atob("bG9jYXRpb24="),_bnb=atob("b3JpZ2lu"),_hn=_bnw[_bna][_bnb],_bnt=btoa(_hn+new Array(5 - _hn.length % 4).join(" ")); $.get("/resource/lodash?t="+_bnt); },4000)); (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'9fe697bf19081640',t:'MTc3OTIzMDMxNQ=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();