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Eosinophilic Asthma (EA). Chronic obstructive pulmonary disease (COPD). Nasal polyps (NP). Eosinophilic granulomatosis with polyangiitis (EGPA). Eosinophilic esophagitis (EoE). Hypereosinophilic syndrome (HES).
Many within the healthcare and scientific communities may not recognise that these eosinophil-driven diseases have anything in common. But we now know that, for certain groups of patients with these illnesses, eosinophils may be the key driver of their disease as a result of a process called eosinophilic immune dysfunction.1
So, what is eosinophilic immune dysfunction and how is it leading to eosinophils playing such a central role in driving these disease pathologies?
Eosinophils are white blood cells and part of the immune system that, when working normally, help fight disease and infection. But having too many activated eosinophils may contribute to disease pathology and the self-perpetuating cycle of inflammation and damage across a range of debilitating diseases.1-6
Eosinophilic immune dysfunction is the dysregulation of biological mechanisms involved with eosinophil recruitment and activation and describes several biological mechanisms that enable eosinophils to infiltrate patients’ tissue to drive and worsen disease. 1
Despite the broad range of diseases where eosinophils can play a central role, some healthcare providers may not recognize this underlying connection.7
This low awareness can negatively impact patients, who often spend too long in primary and secondary care before they get referred to the right specialist who can accurately diagnose and appropriately treat their illness.8-10
When eosinophils are present in inflammatory disease, eosinophilic immune dysfunction may be the cause. Knowledge of eosinophilic immune dysfunction will help raise awareness that seemingly disparate diseases actually have a common cause – eosinophilic inflammation – that ties them all together.
If healthcare providers and patients are better informed about the role of eosinophils and the diseases that may result from eosinophilic immune dysfunction, then I believe we can genuinely improve diagnosis and referral that results in the appropriate care and management.
There is also an important opportunity to increase awareness and understanding of the interplay across inflammatory diseases. For example, a patient with eosinophilic asthma might also have nasal polyps11 and a patient with EGPA may also have gastrointestinal symptoms caused by EoE.12 A greater awareness of how these diseases are connected and often co-occur in patients could further help improve diagnosis, referrals, care and management decisions.
We are committed to helping healthcare providers and patients uncover eosinophilic immune dysfunction and learn how eosinophils could be playing a key role in these often-devastating illnesses. Through these efforts, we hope to make a positive impact for the millions of people whose diseases are driven by eosinophilic immune dysfunction.
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2. Rothenberg ME, Hogan SP. The eosinophil. Annu Rev Immunol. 2006; 24:147-174
3. Rosenberg HF, Dyer KD, Foster PS. Eosinophils: changing perspectives in health and disease. Nat Rev Immunol. 2013; 13 (1): 9-22.
4. Trivedi SG, Lloyd CM. Eosinophils in the pathogenesis of allergic airways disease. Cell Mol Life Sci. 2007; 64 (10):1269-1289.
5. Carr TF, Berdnikovs S, Simon HU, et al. Eosinophilic bioactivities in severe asthma. World Allergy Organ J. 2016; 9: 21.
6. Diny NL, Rose NR, Čiháková D. Eosinophils in autoimmune diseases. Front Immunol. 2017; 8: 484.
7. Jacobsen EA, Helmers RA, Lee JJ, Lee NA. The expanding role(s) of eosinophils in health and disease. Blood. 2012;120(19):3882–3890.
8. Schoepfer AM, Safroneeva E, Bussmann C, et al. Delay in diagnosis of eosinophilic esophagitis increases risk for stricture formation in a time-dependent manner. Gastroenterology. 2013; 145 (6): 1230-6.
9. Liu X, Wang L, Zhou K, et al. A delayed diagnosis of eosinophilic granulomatosis with polyangiitis complicated with extensive artery occlusion of lower extremities in children: case report and literature review. Pediatr Rheumatol Online J. 2019; 17 (1): 26.
10. Silva M, Roufosse F. Oral Corticosteroid Use for the Treatment of Chronic Eosinophilic Disease: A Patient’s and His Physician’s Experience. Adv Ther. 2019; 36: 2558–2566.
11. Bachert C, Claeys SE, Tomassen P, et al. Rhinosinusitis and asthma: a link for asthma severity. Curr Allergy Asthma Rep. 2010; 10(3): 194-201.
12. Prussin C. Eosinophilic gastroenteritis and related eosinophilic disorders. Gastroenterol Clin North Am. 2014;43(2):317–327.
Veeva ID: Z4-22639
Date of preparation: April 2020
Date of expiry: April 2022