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. 2023 May 17:14:1192284.
doi: 10.3389/fimmu.2023.1192284. eCollection 2023.

Management of eosinophil-associated inflammatory diseases: the importance of a multidisciplinary approach

Santiago Quirce  1   2 , Borja G Cosío  1   3 , Agustín España  4 , Ricardo Blanco  5 , Joaquim Mullol  1   6 , Cecilio Santander  7   8 , Victoria Del Pozo  1   8   9
Affiliations

Management of eosinophil-associated inflammatory diseases: the importance of a multidisciplinary approach

Santiago Quirce et al. Front Immunol. .

Abstract

Elevated eosinophil counts in blood and tissue are a feature of many pathological processes. Eosinophils can migrate and accumulate in a wide variety of tissues and, by infiltrating a target organ, can mediate the development of several inflammatory diseases. The normalization of eosinophilia is a common biomarker of a treatable trait and can also be used as a prognostic and predictive biomarker since it implies a reduction in type 2 inflammation that contributes to disease pathogenesis. Biological therapies targeting this cell type and its proinflammatory mediators have been shown to be effective in the management of a number of eosinophilic diseases, and for this reason they constitute a potential common strategy in the treatment of patients with various multimorbidities that present with type 2 inflammation. Various biological options are available that could be used to simultaneously treat multiple target organs with a single drug, bearing in mind the need to offer personalized treatments under the umbrella of precision medicine in all patients with eosinophil-associated diseases (EADs). In addition to reviewing these issues, we also discuss a series of perspectives addressing the management of EAD patients from a multidisciplinary approach, with the collaboration of health professionals from different specialties who manage the different multimorbidities that frequently occur in these patients. We examine the basic principles of care that this multidisciplinary approach must cover and present a multidisciplinary expert opinion regarding the ideal management of patients with EADs, from diagnosis to therapeutic approach and follow-up.

Keywords: eosinophil; eosinophil-associated disease; eosinophilic inflammation; expert opinion; multidisciplinary management.

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Conflict of interest statement

Author SQ has received advisor’s and speaker’s honoraria from ALK, Allergy Therapeutics, AstraZeneca, GlaxoSmithKline, LETI Pharma, Novartis, Chiesi, Mundipharma, Teva, and Sanofi. Author BC has received advisor’s and speaker’s honoraria from AstraZeneca, GlaxoSmithKline, Chiesi, Menarini, Novartis, Teva, and Sanofi. Author RB has received advisor’s and speaker’s honoraria from AbbVie, Lilly, Pfizer, Roche, BMS, Janssen and MSD, and research funding from AbbVie, MSD, Lilly and Roche. Author JM has received advisor’s, consultant’s and speaker’s honoraria, and research funding, from AstraZeneca, Genentech-Roche, GSK, LETI, Menarini, MSD, Mitsubishi-Tanabe, NOUCOR/Uriach Group, Novartis, OPTINOSE, Proctor & Gamble, Regeneron Pharmaceuticals Inc., Sanofi-Genzyme, UCB Pharma, and Viatris/MEDA Pharma. Author CS has received consultant’s and trainer’s honoraria from Laborie/MMS, Medtronic Covidien AG, Menarini Consumer Healthcare, Doctaforum Medical Marketing S. L., ISOMED PHARMA S. L. and AstraZeneca and has received research funding from AstraZeneca, EsoCap Biotech, Regeneron Pharmaceuticals Inc., Celldex Therapeutics, Adare Pharmaceuticals Inc., and Dr. Falk Pharma GmbH. Author VP has received advisor’s and speaker´s honoraria, and research funding, from AstraZeneca and GlaxoSmithKline. The remaining author declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.​

Figures

Figure 1
Figure 1
The eosinophil as the main cell responsible for diseases that present with eosinophilic inflammation. (A) The eosinophilic inflammation cycle. (B) Migration of eosinophils to the different tissues in which they cause eosinophilic diseases. COPD, chronic obstructive pulmonary disease; DRESS, drug reaction with eosinophilia and systemic symptoms; ECRS, eosinophilic chronic rhinosinusitis; EGPA, eosinophilic granulomatosis with polyangiitis; GM-CSF, granulocyte macrophage colony-stimulating factor; HES, hypereosinophilic syndrome; IL, interleukin; NARES, non-allergic rhinitis with eosinophilia syndrome; N-ERD, nonsteroidal anti-inflammatory drug-exacerbated respiratory disease; T2, type 2 immune response.
Figure 2
Figure 2
Perspectives on the ideal pathway for the multidisciplinary management of eosinophilic diseases. CRSwNP, chronic rhinosinusitis with nasal polyps; EGPA, eosinophilic granulomatosis with polyangiitis; EoE, eosinophilic esophagitis; N-ERD, nonsteroidal anti-inflammatory drug-exacerbated respiratory disease; OME, otitis media with effusion.
See this image and copyright information in PMC

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