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Updated: Sep 16, 2025
03:23
Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
923
Eosinophils in asthma phenotypes: perpetrators or guilty by association?
Marek Lommatzsch1, Roland Buhl2, Karl-Christian Bergmann3
1Department of Pneumology, University of Rostock, Rostock, Germany; Intensive Care Medicine, University of Rostock, Rostock, Germany.
The Lancet. Respiratory Medicine
|July 11, 2025
Summary
Eosinophils play different roles in allergic asthma subtypes. Adult-onset asthma shows persistently high eosinophils crucial for disease, unlike early-onset asthma where they are less critical.
Area of Science:
- Immunology
- Pulmonology
- Allergy
Background:
- Twenty-five years after mepolizumab trials, new evidence re-evaluates eosinophil roles in asthma.
- Asthma phenotypes exhibit distinct pathogenetic mechanisms involving eosinophils.
Purpose of the Study:
- To differentiate the pathogenetic role of eosinophils in early-onset versus adult-onset asthma.
- To inform diagnosis and treatment strategies for asthma phenotypes based on eosinophil involvement.
Main Methods:
- Review of accumulated evidence on eosinophil counts and function in allergic asthma.
- Analysis of clinical trial data and pathogenetic insights into asthma phenotypes.
Main Results:
- Eosinophils are variable and play a minor role in allergen-driven, early-onset asthma.
- Persistently elevated eosinophils are key drivers in intrinsic, adult-onset asthma.
Conclusions:
- Eosinophilia is not a universal treatable trait but a diagnostic complement for asthma.
- Accurate asthma phenotyping is crucial for selecting appropriate biologic therapies.
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