Dupilumab is a biologic agent approved for severe eosinophilic/atopic asthma. Which cytokine signaling pathway does it target?

• A Neutralizes IL-5 specifically to reduce eosinophil production and survival
• B Inhibits IL-33 binding to ST2, preventing mast cell and ILC2 activation
• C Blocks IL-4 receptor alpha (IL-4Rα) subunit shared by both IL-4 and IL-13 receptors, inhibiting type 2 (Th2) inflammation driving airway hyperresponsiveness, mucus hypersecretion, and IgE production ✓
• D Blocks TSLP receptor on dendritic cells, preventing T cell priming

Explanation

Dupilumab is a fully human monoclonal antibody that blocks the IL-4 receptor alpha (IL-4Rα) subunit. The IL-4Rα subunit is the shared component of both the type I IL-4 receptor (IL-4Rα + gamma-c chain, expressed on hematopoietic cells) and the type II IL-4 receptor (IL-4Rα + IL-13Rα1, expressed on non-hematopoietic cells including bronchial epithelium). By blocking IL-4Rα, dupilumab simultaneously inhibits both IL-4 and IL-13 signaling — the key cytokines driving Th2/type 2 inflammation, IgE class switching, goblet cell hyperplasia, and airway remodeling. This broad dual blockade distinguishes dupilumab from agents targeting IL-5 alone (mepolizumab, benralizumab) or IL-13 alone.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.