scholarly journals Blood Eosinophils Subtypes and Their Survivability in Asthma Patients

Cells ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 1248 ◽  
Author(s):  
Andrius Januskevicius ◽  
Egle Jurkeviciute ◽  
Ieva Janulaityte ◽  
Virginija Kalinauskaite-Zukauske ◽  
Skaidrius Miliauskas ◽  
...  
Keyword(s):  
Magnetic Beads ◽  
Allergen Challenge ◽  
Annexin V ◽  
Surface Protein ◽  
Control Group ◽  
Blood Eosinophil ◽  
Eosinophilic Asthma ◽  
Asthma Patients ◽  
Surface Protein Expression ◽  
Blood Eosinophils

Eosinophils subtypes as lung-resident (rEOS) and inflammatory (iEOS) eosinophils are different in surface protein expression, functions, response to IL-5 and localization in lungs. rEOS- and iEOS-like eosinophils are found in blood; thus, we aimed to investigate their quantity and survivability in asthma patients. A total of 40 individuals were included: 10 steroid-free non-severe allergic asthma (AA), and 18 severe non-allergic eosinophilic asthma (SNEA) patients, the control group consisted of 12 healthy non-smoking subjects (HS). A bronchial challenge with Dermatophagoides pteronysinnus allergen was performed for AA patients and HS. Blood eosinophils subtyping was completed with magnetic beads’ conjugated antibodies against surface CD62L. Eosinophils adhesion to hTERT airway smooth muscle (ASM) cells was measured by evaluating their peroxidase activity and viability by annexin V and propidium iodide staining. We found that the predominant blood eosinophil subtype in AA patients was iEOS, while rEOS prevailed in SNEA patients (p < 0.05). Moreover, rEOS demonstrated higher adhesion intensity compared with iEOS in all investigated groups. Both eosinophils subtypes of SNEA patients had higher survivability over the AA group. However, iEOS survivability from AA and SNEA groups was higher compared with rEOS under standard conditions, when rEOS survivability increased after their incubation with ASM cells. Bronchial allergen challenge abolished the dominance of blood iEOS in AA patients and prolonged only iEOS survivability. Though the challenge did not affect the adhesion of any eosinophils subtypes, the direct dependence of rEOS and iEOS survivability on their interaction with ASM cells was revealed (p < 0.05). These findings provide the premise for eosinophils subtype-oriented asthma treatment.

Diagnosis and Management of Severe Asthma

2018 ◽  
Vol 39 (01) ◽  
pp. 091-099 ◽  
Author(s):  
Kian Fan Chung
Keyword(s):  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Immunoglobulin E ◽  
High Dose ◽  
Blood Eosinophil ◽  
Exhaled Breath ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Asthma Patients ◽  
Long Acting

AbstractSevere therapy-resistant asthma has been defined as “asthma which requires treatment with high dose inhaled corticosteroids (ICSs) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming ‘uncontrolled’ or which remains ‘uncontrolled’ despite this therapy”. Patients who usually present with ‘difficult-to-treat asthma’ should first be assessed to determine whether he/she has asthma with the exclusion of other diagnoses and if so, whether the asthma can be classified as severe therapy-resistant. This necessitates an assessment of adherence to medications, confounding factors, and comorbidities. Increasingly, management of severe therapy-resistant asthma will be helped by the determination of phenotypes to optimize responses to existing and new therapies. Severe asthma patients are usually on a combination of high dose ICS and long-acting β-agonist (LABA) and, in addition, are often on a maintenance dose of oral corticosteroids. Phenotyping can be informed by measuring blood eosinophil counts and the level of nitric oxide in exhaled breath, and the use of sputum granulocytic counts. Severe allergic asthma and severe eosinophilic asthma are two defined phenotypes for which there are efficacious targeted biologic therapies currently available, namely anti-immunoglobulin E (IgE) and anti-interleukin (IL)-5 antibodies, respectively. Further progress will be realized with the definition of noneosinophilic or non-T2 phenotypes. It will be important for patients with severe asthma to be ultimately investigated and managed in specialized severe asthma centers.

scholarly journals Increased Peripheral Blood Eosinophils may Indicate Acute Infection in Neonates

2021 ◽  
Author(s):  
Weiying Wang ◽  
Yuan Zhao ◽  
Bi-Fen Yuan
Keyword(s):  
Peripheral Blood ◽  
Medical Center ◽  
Acute Infection ◽  
White Blood Cells ◽  
Disease Stage ◽  
Control Group ◽  
Blood Eosinophil ◽  
Acute Infections ◽  
Significant Difference ◽  
Blood Eosinophils

Abstract Objective To explore the association between increased blood eosinophils and frequent pathogens due to the infections in children. Methods A total of 2353 children with acute infections admitted to Guangzhou Women and Children's Medical Center from February 1, 2019 to January 31, 2020 were enrolled in the study. 277 children without infections were comprised the control group. Children’s age, peripheral blood parameters including white blood cells, eosinophils, C-reactive protein (CRP) were recorded. In addition, infection stage and departments the patients admitted to were investigated. Results Blood eosinophil numbers negatively correlated with the age of children, whereas had no relation to disease stage. The means of eosinophil for neonates (<0.1 year)，infancy (<1year) and children >1year with acute infections were 0.67±0.40, 0.40±0.68, 0.15±0.25 *109/L compared with control group matched for age(0.44±0.20, 0.45±0.27, 0.24±0.19*109/L, P <0.001, <0.001, 0.497, respectively). Among them, the mean of eosinophil in the neonates afflicted with acute infections was significantly higher than the others compared to age-matched controls (0.63±0.60 vs 0.44±0.20, P= 0.012). Areas under the curves (AUC) were 0.81 (95% CI 0.75–0.86) for eosinophil combined with CRP and 0.68 (95% CI 0.61–0.75) for CRP alone for acute infections in neonates (P=0.02). Patients admitted in ICU had higher eosinophils than outpatients (0.46±0.60 vs 0.16±0.24, P <0.001) but had no significant difference compared with control group (0.45±0.20, P >0.99). Conclusion Increased peripheral blood eosinophils may indicate acute infections among neonates. Eosinophil combined with CRP can contribute to evaluating this population.

scholarly journals Food allergy as an asthma comorbidity in children and adolescents: a practical approach through a real-world study

2021 ◽  
Vol 49 (1) ◽  
pp. 68-78
Author(s):  
Ignacio Esteban-Gorgojo ◽  
María Puy Gorgojo ◽  
Joaquin Sastre ◽  
Santiago Quirce
Keyword(s):  
Food Allergy ◽  
Real World ◽  
Lipid Transfer Protein ◽  
Asthma Patient ◽  
Lipid Transfer ◽  
Eosinophilic Asthma ◽  
Blood Eosinophilia ◽  
Transfer Protein ◽  
Asthma Patients ◽  
Blood Eosinophils

Introduction: Several studies have shown interactions between food allergy (FA) and asthma, but the influence of FA in asthma traits has been scarcely studied. Methods: A real-world retrospective observational study was conducted among patients between 3 and 18 years old referred to our Asthma Clinic from November 2014 to November 2017. Data were obtained from daily clinical practice. Only patients properly diagnosed with asthma and FA were included. Results: 815 patients were included: 483 asthmatics and 332 non-asthmatics and 180 FA and 635 no FA. Food allergy was statistically more prevalent among asthma patients (p = 0.014). In a high pollen exposure area, Madrid, among subjects with asthma (121 FA, 362 no-FA), sensitization to lipid transfer protein (LTP) (p = 0.016, OR: 3.064, RR: 2.512) and pollen (p = 0.016, OR: 3.064, RR: 2.512) are risk factors to have a concomitant FA diagnosis, whereas sensitization to profilin is not. Peripheral blood eosinophils were higher in subjects with asthma and FA (≥450 eos/µL) than in asthmatics without FA (≤300 eos/µL) (p = 0.031). Blood eosinophilia, using a cut-off >300 eos/µL, was only present in the FA group. Therefore, this trait should be considered when phenotyping a patient as eosinophilic asthma. Sex had an impact on several variables: height, weight, BMI, blood eosinophils count, sensitization profile, and early-onset asthma. Conclusions: Asthma and FA are closely related and the presence of FA should be investigated in every asthma patient. This study shows an association between asthma with concomitant FA and sensitization to pollen and LTP, blood eosinophilia, and growth alterations. Differences between boys and girls were also described, so a sex-specific approach is recommended.

scholarly journals Mepolizumab improves sino-nasal symptoms and asthma control in severe eosinophilic asthma patients with chronic rhinosinusitis and nasal polyps: a 12-month real-life study

2021 ◽  
Vol 15 ◽  
pp. 175346662110093
Author(s):  
Aikaterini Detoraki ◽  
Eugenio Tremante ◽  
Maria D’Amato ◽  
Cecilia Calabrese ◽  
Claudia Casella ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Asthma Control ◽  
Real Life ◽  
Blood Eosinophil ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Nasal Symptoms ◽  
Asthma Patients ◽  
Nasal Cytology ◽  
Snot 22

Background: Severe eosinophilic asthma is frequently associated to chronic rhinosinusitis and nasal polyposis (CRSwNP) that contribute to poor asthma control. Mepolizumab is an anti-IL-5 monoclonal antibody, approved for the treatment of severe eosinophilic asthma. A limited number of studies have assessed the efficacy of mepolizumab on CRSwNP in severe asthmatics. We aim to evaluate the efficacy of mepolizumab on sino-nasal symptoms, polyp growth and asthma control in severe eosinophilic asthma patients with CRSwNP in real life. Methods: In this study 44 severe eosinophilic asthma patients with CRSwNP were treated with mepolizumab (100 mg q4w) for 1 year. The following outcomes were assessed before (T0), after 6 (T6) and 12 months (T12) of treatment: sino/nasal outcome test (SNOT-22), Total Endoscopic Nasal Polyp Score (TENPS), %FEV1 (FEV1/FEV1 predicted) and Asthma control test (ACT). Blood eosinophil count, exhaled nitric oxide (FENO) and prednisone intake were measured. In a subgroup of patients, nasal cytology was performed before (T0), after 6 (T6) and after 12 months (T12) of treatment with mepolizumab. Results: We reported a significant reduction of SNOT-22 [from 51.5 ± 21.2 at baseline (T0) to 31.70 ± 17.36 at T6 and 29.7 ± 21.5 at T12 (T0–T12 p < 0.001)] and a decrease of TENPS (from 2.88 ± 3.07 to 1.70 ± 2.37 and 1.77 ± 2.56 at T0, T6 and T12, respectively, T0–T12 p = 0.99). A significant improvement of %FEV1, ACT and a decrease in blood eosinophils and mean prednisone intake were also reported. No statistically significant decreasing trend was measured for FENO. Nasal cytology findings suggest a significant reduction of eosinophil percentage following mepolizumab treatment (from 16.8 ± 7.2% to 3.6 ± 6.2% and 0.8 ± 2.4% at T0, T6 and T12 respectively, T0 to T12: p < 0.001). Conclusions: Mepolizumab improves sino-nasal and asthma symptoms and reduces polyp growth in patients with severe eosinophilic asthma and concomitant CRSwNP in real life. The reviews of this paper are available via the supplemental material section.

scholarly journals Clinical profile of patients with adult-onset eosinophilic asthma

2016 ◽  
Vol 2 (2) ◽  
pp. 00100-2015 ◽  
Author(s):  
Jantina C. de Groot ◽  
Huib Storm ◽  
Marijke Amelink ◽  
Selma B. de Nijs ◽  
Edwin Eichhorn ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Inhaled Corticosteroids ◽  
Early Recognition ◽  
Airflow Limitation ◽  
Blood Eosinophil ◽  
Adult Onset ◽  
Air Trapping ◽  
Eosinophilic Asthma ◽  
Computed Tomography Scanning ◽  
Blood Eosinophils

Adult-onset eosinophilic asthma is increasingly recognised as a severe and difficult-to-treat subtype of asthma. In clinical practice, early recognition of patients with this asthma subtype is important because it may have treatment implications. Therefore, physicians need to know the distinct characteristics of this asthma phenotype. The objective of the present study was to determine the characteristic profile of patients with adult-onset eosinophilic asthma.130 patients with adult-onset (>18 years of age) asthma and high blood eosinophil counts (≥0.3×109 L−1) were compared with 361 adult-onset asthma patients with low (<0.3×109 L−1) blood eosinophils. Measurements included a series of clinical, functional and imaging parameters.Patients with high blood eosinophils were more often male, had less well controlled asthma and higher exacerbation rates, despite the use of higher doses of inhaled corticosteroids. They had higher levels of total IgE without more sensitisation to common inhaled allergens. In addition, these patients had worse lung function, and more often showed fixed airflow limitation, air trapping, nasal polyposis and abnormalities on sinus computed tomography scanning. Chronic rhinosinusitis, air trapping and male sex were three independent factors associated with blood eosinophilia (adjusted OR 3.8 (95% CI 1.7–8.1), 3.0 (95% CI 1.1–8.1) and 2.4 (95% CI 1.3–4.4), respectively).Patients with adult-onset asthma with elevated blood eosinophils exhibit a distinct profile, which can readily be recognised in clinical practice.

scholarly journals In Vivo Allergen-Activated Eosinophils Promote Collagen I and Fibronectin Gene Expression in Airway Smooth Muscle Cells via TGF-β1 Signaling Pathway in Asthma

2020 ◽  
Vol 21 (5) ◽  
pp. 1837 ◽  
Author(s):  
Ieva Janulaityte ◽  
Andrius Januskevicius ◽  
Virginija Kalinauskaite-Zukauske ◽  
Ieva Bajoriuniene ◽  
Kestutis Malakauskas
Keyword(s):  
Gene Expression ◽  
Inflammatory Responses ◽  
Allergen Challenge ◽  
Airway Smooth Muscle Cells ◽  
Asthma Patients ◽  
Blood Eosinophils ◽  
Culture Supernatants ◽  
Tgf Β1 ◽  
Bronchial Allergen Challenge

Eosinophils infiltration and releasing TGF-β1 in the airways has been implicated in the pathogenesis of asthma, especially during acute episodes provoked by an allergen. TGF-β1 is a major mediator involved in pro-inflammatory responses and fibrotic tissue remodeling in asthma. We aimed to evaluate the effect of in vivo allergen-activated eosinophils on the expression of COL1A1 and FN in ASM cells in asthma. A total of 12 allergic asthma patients and 11 healthy subjects were examined. All study subjects underwent bronchial challenge with D. pteronyssinus allergen. Eosinophils from peripheral blood were isolated before and 24 h after the bronchial allergen challenge using high-density centrifugation and magnetic separation. Individual co-cultures of blood eosinophils and immortalized human ASM cells were prepared. The TGF-β1 concentration in culture supernatants was analyzed using ELISA. Gene expression was analyzed using qRT-PCR. Eosinophils integrins were suppressed with linear RGDS peptide before co-culture with ASM cells. Results: The expression of TGF-β1 in asthmatic eosinophils significantly increased over non-activated asthmatic eosinophils after allergen challenge, p < 0.001. The TGF-β1 concentration in culture supernatants was significantly higher in samples with allergen-activated asthmatic eosinophils compared to baseline, p < 0.05. The effect of allergen-activated asthmatic eosinophils on the expression of TGF-β1, COL1A1, and FN in ASM cells was more significant compared to non-activated eosinophils, p < 0.05, however, no difference was found on WNT-5A expression. The incubation of allergen-activated asthmatic eosinophils with RGDS peptide was more effective compared to non-activated eosinophils as the gene expression in ASM cells was downregulated equally to the same level as healthy eosinophils.

scholarly journals Effect of Giving Polyphytopharmaca on Improvement in The Degree of Asthma Control through Reduction of Eosinophils and Interleukin-13 Uncontrolled Asthma Patients

2020 ◽  
Vol 40 (3) ◽  
pp. 130-138
Author(s):  
Aditya Sri Listyoko ◽  
Iin Noor Chozin ◽  
Susanthy Djajalaksana
Keyword(s):  
Asthma Control ◽  
Nigella Sativa ◽  
Asthma Management ◽  
Test Methods ◽  
Blood Analysis ◽  
Blood Eosinophil ◽  
Immunological Mechanism ◽  
Asthma Patients ◽  
Act Score ◽  
Blood Eosinophils

Backgrounds: Bronchial asthma is a heterogeneous disease characterized with chronic airway inflammation. The level of asthma control is an indicator of asthma management outcomes. It is influenced by a complex immunological mechanism, included the role of IL-13 as a key biomarker of inflammation. We investigate the effect of Poly-Phytopharm (Kleinhovia hospita 100 mg, Curcuma xanthorriza 75 mg, Nigella sativa 100 mg and Ophiocephalus striatus 100 mg) on the level of asthma control tests (ACT) score, blood eosinophils, and serum IL-13 on not fully controlled asthma stable patients. Methods: This study used quasi-experimental pre and post test methods, in 15 stable asthma patients who were not fully controlled at the pulmonary outpatient clinic of Dr. Saiful Anwar General Hospital, Malang. Assessment of ACT score, blood eosinophils, and serum IL-13 are carried out before and after supplementation of Poly-Phytopharm three times a day, two capsules respectively for 12 weeks. The ACT was scored by the investigator by direct questioning of patients, the blood eosinophil was measured with blood analysis, and the IL-13 in serum was detected with qPCR method. Results: There is significant increase of ACT score (18.07±2.57 to 22.06±1.83; P=0.001). In subject with baseline eosinophils ≥300 pg/mL (n=9), there were significant reduction in blood eosinophils (653.15±276.77/µL to 460.66±202.04/µL; P=0.038), and a decrease of serum IL-13 (17.69±9.901 pg/ml to 16.17±12.438 pg/ml; P=0.609). Conclusions: The administration of poly-phytopharm for 12 weeks improves ACT level, decreases blood eosinophils, and decrease serum IL-13 on not fully controlled asthma stable patients. (J Respir Indo. 2020; 40(3): 130-8)

scholarly journals α4β1 and αMβ2 Integrin Expression and Pro-Proliferative Properties of Eosinophil Subtypes in Asthma

2021 ◽  
Vol 11 (9) ◽  
pp. 829
Author(s):  
Egle Jurkeviciute ◽  
Andrius Januskevicius ◽  
Airidas Rimkunas ◽  
Jolita Palacionyte ◽  
Kestutis Malakauskas
Keyword(s):  
Gene Expression ◽  
Cell Proliferation ◽  
Allergen Challenge ◽  
Annexin V ◽  
Magnetic Bead ◽  
Systemic Circulation ◽  
Integrin Subunit ◽  
Eosinophilic Asthma ◽  
Severe Allergic Asthma ◽  
Bronchial Allergen Challenge

Eosinophilic inflammation is one of the main pathophysiological features in asthma. Two subtypes of eosinophils exist in the lung and systemic circulation: lung-resident eosinophils (rEOS) and inflammatory eosinophils (iEOS). We evaluated the expression of α4β1 and αMβ2 integrins of eosinophil subtypes and their influence on airway smooth muscle (ASM) cell proliferation and viability in asthma. We included 16 severe non-allergic eosinophilic asthma (SNEA) patients, 13 steroid-free, non-severe allergic asthma (AA) patients, and 12 healthy control subjects (HS). For AA patients, a bronchial allergen challenge with Dermatophagoides pteronyssinus was performed. The eosinophil subtypes were distinguished using magnetic bead-labeled antibodies against surface CD62L, and individual combined cell cultures were prepared with ASM cells. The integrins gene expression was analyzed by a quantitative real-time polymerase chain reaction. Proliferation was assessed by the Alamar blue assay, and viability by annexin V and propidium iodide staining. rEOS-like cells were characterized by the relatively higher gene expression of the β1 integrin subunit, whereas iEOS-like cells were characterized by the αM and β2 integrin subunits. The inclusion of either eosinophil subtypes in co-culture significantly increased the proliferation of ASM cells, and the effect of rEOS-like cells was stronger than iEOS-like cells (p < 0.05). Furthermore, rEOS-like cells had a more pronounced effect on reducing ASM cell apoptosis compared to that of iEOS-like cells (p < 0.05). Lastly, the bronchial allergen challenge significantly enhanced only the iEOS-like cells’ effect on ASM cell proliferation and viability in AA patients (p < 0.05). These findings highlight the different expression of α4β1 and αMβ2 integrins on distinct eosinophil subtypes in asthma. Therefore, rEOS-like cells have a stronger effect in stimulating ASM cell proliferation and viability; however, contact with specific allergens mainly enhances pro-proliferative iEOS-like cell properties.

scholarly journals Increased Peripheral Blood Eosinophils May Indicate Acute Infection in Neonates

2021 ◽  
Author(s):  
Weiying Wang ◽  
Yuan Zhao ◽  
Bi-Fen Yuan
Keyword(s):  
Peripheral Blood ◽  
Medical Center ◽  
Acute Infection ◽  
White Blood Cells ◽  
Disease Stage ◽  
Control Group ◽  
Blood Eosinophil ◽  
Acute Infections ◽  
Significant Difference ◽  
Blood Eosinophils

Abstract BackgroundEosinophils are now being recognized for more varied functions such as antiviral and bactericidal effects. This study aimed to explore the association between increased blood eosinophils and frequent pathogens due to the infections in children. Methods A total of 2353 children with acute infections admitted to Guangzhou Women and Children's Medical Center from February 1, 2019 to January 31, 2020 were enrolled in the study. 277 children without infections were comprised the control group. Children’s age, peripheral blood parameters including white blood cells, eosinophils, C-reactive protein (CRP) were recorded. In addition, infection stage and departments the patients admitted to were investigated. The study protocol was approved by the institutional ethics committee of the Guangzhou Women and Children's Medical Center (NO.2020110819342581).Results Blood eosinophil numbers negatively correlated with the age of children, whereas had no relation to disease stage. The means of eosinophil for neonates (<0.1 year)，infancy (<1year) and children >1year with acute infections were 0.67±0.40, 0.40±0.68, 0.15±0.25 *109/L compared with control group matched for age(0.44±0.20, 0.45±0.27, 0.24±0.19*109/L, P <0.001, <0.001, 0.497, respectively). Among them, the mean of eosinophil in the neonates afflicted with acute infections was significantly higher than the others compared to age-matched controls (0.63±0.60 vs 0.44±0.20, P= 0.012). Areas under the curves (AUC) were 0.81 (95% CI 0.75–0.86) for eosinophil combined with CRP and 0.68 (95% CI 0.61–0.75) for CRP alone for acute infections in neonates (P=0.02). Patients admitted in ICU had higher eosinophils than outpatients (0.46±0.60 vs 0.16±0.24, P <0.001) but had no significant difference compared with control group (0.45±0.20, P >0.99). Conclusion Increased peripheral blood eosinophils may indicate acute infections among neonates. Eosinophil combined with CRP can contribute to evaluating this population.

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