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Review
. 2024 Mar 21:8:40-50.
doi: 10.5414/ALX02469E. eCollection 2024.

Eosinophil granulocytes in chronic inflammatory respiratory diseases and CRSwNP: Function, immunological basis, and clinical significance

Felix Klimek  1 , Christoph Bergmann  2 , Jan Hagemann  3 , Mandy Cuevas  4 , Sven Becker  5 , Oliver Pfaar  6 , Ingrid Casper  1 , Ludger Klimek  1
Affiliations
Review

Eosinophil granulocytes in chronic inflammatory respiratory diseases and CRSwNP: Function, immunological basis, and clinical significance

Felix Klimek et al. Allergol Select. .

Abstract

Introduction: Eosinophils play an important regulatory and immunomodulatory role in airway mucosa and have antiparasitic and antiviral properties as well as pro-inflammatory effects that may also cause persistence of inflammation with tissue remodeling. The number of eosinophils and the detection of specific mediators in biological samples from, e.g., blood, nasal secretions, and bronchial fluid can serve as biomarkers that reflect the underlying pathophysiology of certain diseases, predict treatment success, and detect therapy effects.

Materials and methods: A literature search was conducted to determine the immunologic basis, mode of action, clinical significance, and available evidence for therapeutic approaches using eosinophil-targeted monoclonal antibodies by searching Medline, Pubmed, and the national and international trial database (ClinicalTrials.gov) and guideline registries as well as the Cochrane Library. Human studies published on the topic in the period up to and including 10/2023 were considered.

Results: Based on the international literature and previous experience, the results are summarized, and recommendations are given.

Conclusion: The important role of eosinophils in immunological processes in the airway mucosa is comprehensively analyzed and can serve as a basis for current and future treatment approaches.

Keywords: CRSwNP; allergic rhinitis; asthma; benralizumab; biologicals; eosinophils; mepolizumab; mucositis; reslizumab.

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Conflict of interest statement

J. Hagemann received grants from Novartis Pharma GmbH, GlaxoSmithKline Deutschland GmbH, Sanofi, HAL Allergy for advisory boards and lectures outside the submitted work. M. Cuevas has received honoraria from ALK-Abelló, Allergopharma, AstraZeneca, Bencard Allergie/ Allergy Therapeutics, GalaxoSmithKline, HAL Allergy, Leti Pharma, Novartis, Roxall, Sanofi-Aventis, Stallergenes outside the submitted work and memberships in the following organizations: AeDA, DGHNO. L. Klimek has received research grants and/or lecture honoraria from Allergy Therapeutics/Bencard, UK/Germany; ALK-Abelló, Denmark; Allergopharma, Germany; ASIT Biotech, Belgium; AstraZeneca, Sweden, Bionorica, Germany; Biomay, Austria, Boehringer Ingelheim, Germany, Circassia, USA; Stallergene, France; Cytos, Switzerland; Curalogic, Denmark; HAL, Netherlands; Hartington, Spain; Lofarma, Italy; MEDA/Mylan, Sweden/USA; Novartis, Switzerland, Leti, Spain; ROXALL, Germany; GlaxoSmithKline (GSK), UK; Sanofi, France and/or acted as a consultant for the above-mentioned pharmaceutical companies. Dr. Klimek is editor of Allergo Journal and Allergo Journal International and is the current President of AeDA (Medical Association of German Allergists) and Vice President of EAACI. O. Pfaar reports grants and/or personal fees from ALK-Abelló, Allergopharma, Stallergenes Greer, HAL Allergy Holding B.V./HAL Allergie GmbH, Bencard Allergie GmbH/Allergy Therapeutics, Lofarma, ASIT Biotech Tools S.A., Laboratorios LETI/LETI Pharma, GlaxoSmithKline, ROXALL Medizin, Novartis, Sanofi-Aventis and Sanofi-Genzyme, Med Update Europe GmbH, streamedup! GmbH, Pohl-Boskamp, Inmunotek S.L., John Wiley and Sons, AS, Paul-Martini-Stiftung (PMS), Regeneron Pharmaceuticals Inc., RG Aerztefortbildung, Institut für Disease Management, Springer GmbH, AstraZeneca, IQVIA Commercial, Ingress Health, Wort&Bild Verlag, Verlag ME, Procter&Gamble, ALTAMIRA, Meinhardt Congress GmbH, Deutsche Forschungsgemeinschaft, Thieme, Deutsche AllergieLiga e.V., AeDA, Alfried-Krupp Krankenhaus, Red Maple Trials Inc., Königlich Dänisches Generalkonsulat, Medizinische Hochschule Hannover, ECM Expro&Conference Management, Technische Universität Dresden, Lilly, Paul Ehrlich Institut (PEI), Japanese Society of Allergy, Forum für Medizinische Fortbildung, Dustri Verlag, all outside the submitted work and within the last 36 months; and he is member of EAACI Excom, member of ext. board of directors DGAKI; coordinator, main- or co-author of different position papers and guidelines in rhinology, allergology, and allergen-immunotherapy and Associate Editor of the journal(s) Allergy and Clinical Translational Allergy (CTA). S. Becker has received honoraria for lectures, consulting and research from ALK Abéllo, Allergopharme, HAL Allergie, Bencard Allergie, Allergy Therapeutics, Therma Fisher Scientific, Novartis, AstraZeneca, Sanofi Genzyme, GSK, MSD, Mylan, Viatris, Karl Storz GmbH, Altamira, Auris Medical, Smart Reporting, Stryker, Helix Biopharm, BMBF. C. Bergmann, I. Casper, and F. Klimek have no conflict of interest in connection with this work.

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