Evaluation of the impact of genetically engineered biological therapy on HLA-E expression in bronchial asthma and atopic dermatitis

Globally, the prevalence of bronchial asthma (BA) alone reaches 19%, with the number of affected individuals showing an upward trend. Atopic dermatitis (AD) affects 25-30% of children and 7-10% of adults. Remission remains elusive even with advanced genetically engineered biological therapies. Consequently, research into immunopathogenic pathways and the development of novel therapeutic strategies remain critical. A typical representative of “non-classical” HLAs, the HLA-E molecule, is a perspective for study. These molecules are also expressed across various tissues, notably in the respiratory system (bronchial epithelium) and skin keratinocytes. As a cell surface protein, HLA-E participates in diverse immune response pathways. VL9 peptides stabilize HLA-E expression, enabling presentation to its primary receptors, NKG2, on natural killer (NK) cells. In adaptive immunity, HLA-E serves as a ligand for CD8⁺ cytotoxic T cell receptors (TCRs). This study aimed to evaluate HLA-E-bearing cells (CD4⁺, CD8⁺, CD14⁺) in patients with BA and AD, both before and 12 months after initiating genetically engineered biological therapy (GEBT). Peripheral blood mononuclear cells (PBMCs) were analyzed from healthy donors (n = 16), BA patients (n = 4), and AD patients (n = 5). AD patients received dupilumab (300 mg loading dose), while BA patients were treated with benralizumab (30 mg). Prior to therapy, both AD and BA patients exhibited lower proportions of HLA-E-positive CD4⁺ and CD8⁺T cells compared to healthy donors. No significant differences were observed in HLA-E expression on CD14⁺ monocytes. During treatment, HLA-E levels across all cell types in patients reached levels comparable to those in healthy donors. These findings suggest HLA-E’s involvement in disease pathogenesis and the modulating effects of GEBT on HLA-E-positive cell populations.