# Interleukin 5

Interleukin 5 (IL-5) is an interleukin produced by type-2 T helper cells and mast cells.

## Function

Through binding to the interleukin-5 receptor, interleukin 5 stimulates B cell growth and increases immunoglobulin secretion—primarily IgA. It is also a key mediator in eosinophil activation.

## Structure

IL-5 is a 115-amino acid (in human, 133 in the mouse) -long T$_h$2 cytokine that is part of the hematopoietic family. Unlike other members of this cytokine family (namely interleukin 3 and GM-CSF), this glycoprotein in its active form is a homodimer.

## Tissue expression

The IL-5 gene is located on chromosome 11 in the mouse, and chromosome 5 in humans, in close proximity to the genes encoding IL-3, IL-4, and granulocyte-macrophage colony-stimulating factor (GM-CSF), which are often co-expressed in T$_h$2 cells. IL-5 is also expressed by eosinophils and has been observed in the mast cells of asthmatic airways by immunohistochemistry. IL-5 expression is regulated by several transcription factors including GATA3.

## Clinical significance

IL-5 has long been associated with the cause of several allergic diseases including allergic rhinitis and asthma, wherein a large increase in the number of circulating, airway tissue, and induced sputum eosinophils have been observed. Given the high concordance of eosinophils and, in particular, allergic asthma pathology, it has been widely speculated that eosinophils have an important role in the pathology of this disease.
As of 2019, there are two FDA-approved monoclonal antibodies that inhibit IL-5, mepolizumab and reslizumab. Additionally, the antibody benralizumab blocks the interleukin-5 receptor. All three drugs are used to treat severe eosinophilic asthma and eosinophilic granulomatosis with polyangiitis (EGPA). Another antibody, depemokimab (GSK3511294), ultra-long acting IL-5 inhibitor, is under development.
Some hydroxyethylaminomethylbenzimidazole analogs have shown IL-5 inhibition in vitro.

## Effect on eosinophils

Eosinophils are terminally differentiated granulocytes found in most mammals. The principal role of these cells, in a healthy host, is the elimination of antibody bound parasites through the release of cytotoxic granule proteins. Given that eosinophils are the primary IL-5Rα-expressing cells, it is not surprising that this cell type responds to IL-5. In fact, IL-5 was originally discovered as an eosinophil colony-stimulating factor, is a major regulator of eosinophil accumulation in tissues, and can modulate eosinophil behavior at every stage from maturation to survival. Mepolizumab is a monoclonal antibody antagonist IL-5 which can reduce excessive eosinophilia.
In Hodgkin lymphoma, the typically-observed eosinophilia is thought to be attributable to an increased production of IL-5.

## Interactions

IL-5 has been shown to interact with interleukin 5 receptor alpha subunit.

## Receptors

The IL-5 receptor is composed of an α and a βc chain. The α subunit is specific for the IL-5 molecule, whereas the βc subunit also recognised by interleukin 3 (IL-3) and granulocyte-macrophage colony-stimulating factor (GM-CSF). Glycosylation of the Asn196 residue of the Rα subunit appears to be essential for binding of IL-5.