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Monitoring eosinophils to guide therapy with Biologics in Asthma: does the compartment matter?
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  • Leo Koenderman,
  • Marwan Hassani,
  • Manali Mukherjee,
  • Parameswaran Nair
Leo Koenderman
Unviersity Medical Center Utrecht
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Marwan Hassani
Unviersity Medical Center Utrecht
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Manali Mukherjee
McMaster University
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Parameswaran Nair
McMaster University
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Abstract

The role of eosinophils in allergic inflammation is well recognized. In homeostasis these cells are found in multiple healthy tissues including the lung parenchyma, but the function of these resident eosinophils is unknown. Circulating eosinophils are easily quantifiable and have been used to define “eosinophilic phenotype”, and to select patients who are likely to respond to anti-eosinophil and anti-Th2—directed therapies. However, presence of eosinophils in circulation may not necessarily indicate that the eosinophils are key effector cells for an airway disease such as asthma and this may be reason for not all patients responding well to anti-IL5 therapies despite normalization of blood eosinophils. This pro-con commentary examines the role of enumerating circulating vs luminal (sputum) eosinophils (and their activation status) not only to initiate therapies with monoclonal antibodies, but to monitor their clinical response while on therapy.

Peer review status:Published

07 Oct 2020Submitted to Allergy
07 Oct 2020Submission Checks Completed
07 Oct 2020Assigned to Editor
09 Oct 2020Reviewer(s) Assigned
24 Oct 2020Review(s) Completed, Editorial Evaluation Pending
25 Oct 2020Editorial Decision: Revise Minor
10 Nov 20201st Revision Received
11 Nov 2020Submission Checks Completed
11 Nov 2020Assigned to Editor
15 Nov 2020Reviewer(s) Assigned
26 Nov 2020Review(s) Completed, Editorial Evaluation Pending
26 Nov 2020Editorial Decision: Accept
Apr 2021Published in Allergy volume 76 issue 4 on pages 1294-1297. 10.1111/all.14700