Diagnosis and management of eosinophilic asthma: a US perspective

Abstract

Eosinophilic asthma is now recognized as an important subphenotype of asthma based on the pattern of inflammatory cellular infiltrate in the airway. Eosinophilic asthma can be associated with increased asthma severity, atopy, late-onset disease, and steroid refractoriness. Induced sputum cell count is the gold standard for identifying eosinophilic inflammation in asthma although several noninvasive biomarkers, including fractional exhaled nitric oxide and periostin, are emerging as potential surrogates. As novel therapies and biologic agents become increasingly available, there is an increased need for specific phenotype-directed treatment strategies. Greater recognition and understanding of the unique immunopathology of this asthma phenotype has important implications for management of the disease and the potential to improve patient outcomes. The present review provides a summary of the clinical features, pathogenesis, diagnosis, and management of eosinophilic asthma.

Keywords:

• asthma
• eosinophil
• allergy
• Th2
• IL-4
• IL-13

Acknowledgments

This research was supported by a grant from the National Institutes of Health 1K08AI080938-01A1 and the American Lung Association/American Academy of Allergy, Asthma, and Immunology Allergic Respiratory Diseases Award to TAD.

Disclosure

The authors report no conflicts of interest in this work.