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