Dupilumab is a biologic approved for severe asthma uncontrolled on high-dose ICS/LABA. Its specific mechanism targets:
- A Anti-IL-5 monoclonal antibody reducing eosinophil production from bone marrow
- B Anti-IgE monoclonal antibody (similar to omalizumab) preventing mast cell activation
- C Anti-IL-4Rα (shared receptor subunit for IL-4 and IL-13) blockade, preventing both IL-4 and IL-13 signaling — inhibiting Th2 inflammation, IgE class switching, and mucus hypersecretion ✓
- D Anti-TSLP (thymic stromal lymphopoietin) blockade at the epithelial interface
Correct answer: C. Anti-IL-4Rα (shared receptor subunit for IL-4 and IL-13) blockade, preventing both IL-4 and IL-13 signaling — inhibiting Th2 inflammation, IgE class switching, and mucus hypersecretion
Explanation
Dupilumab is a fully human IgG4 monoclonal antibody targeting the IL-4Rα (IL-4 receptor alpha) subunit, which is shared between the type I IL-4 receptor (IL-4Rα/γc) and the type II receptor (IL-4Rα/IL-13Rα1). By blocking IL-4Rα, dupilumab simultaneously inhibits signaling by both IL-4 and IL-13 — key Th2 cytokines driving airway inflammation, goblet cell hyperplasia, mucus production, and IgE synthesis. Mepolizumab/benralizumab target IL-5/IL-5Rα (eosinophilic asthma); omalizumab targets IgE; tezepelumab targets TSLP.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.