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Background: Airway eosinophilic inflammation is a key pathobiologic trait of severe asthma, a complex chronic disease which affects about 5-10% of asthmatic patients worldwide. Therefore, an in-depth knowledge of the immunopathologic mechanisms underlying severe eosinophilic asthma (SEA) is essential to understand the beneficial effects of currently available, eosinophil-targeted anti-asthma treatments, as well as to develop new therapeutic strategies.
Areas Covered: This narrative review article aims to provide a concise coverage of the pathophysiology of severe eosinophilic asthma, followed by an updated overview of current and newly emerging therapeutic approaches capable of counteracting airway eosinophilic inflammation. All information reported comes from an extensive literature search conducted on PubMed.
Expert Opinion: The recent advances regarding our understanding of the proinflammatory pathways characterizing the various SEA endotypes are allowing to shape effective therapeutic options, driven by the accurate selection of relevant molecular targets. Such successful developments are at the basis of the sustained clinical remission of eosinophilic asthma, which today represents a realistic goal for many severe asthmatic patients.
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http://dx.doi.org/10.1080/17476348.2025.2506551 | DOI Listing |
Respir Med
September 2025
Centre of Excellence in Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, New Lambton Heights, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; Department of Respiratory and Sleep Medici
Background: The benefits of oral corticosteroid (OCS) stewardship approaches -including monoclonal antibody treatments for severe asthma- on reducing toxic OCS exposure and related comorbidities such as depression and anxiety require real-world evaluation.
Methods: This real-world observational study investigated OCS exposure and associated complications over 24 months in patients enrolled in the Australian Mepolizumab Registry (n=412).
Results: Patients were median age 59 years, 58% were female.
J Asthma
September 2025
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Objective: Small airway dysfunction (SAD) is a common feature of bronchial asthma. However, its association with asthma phenotypes remains poorly understood. This study aimed to assess the prevalence of oscillometry-defined SAD in steroid-naïve adult bronchial asthma and to explore its association with asthma phenotypes based on peripheral blood eosinophil count (BEC).
View Article and Find Full Text PDFJ Med Cases
August 2025
Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.
Hypereosinophilic syndrome (HES) is a hematologic disorder characterized by an increased absolute eosinophil count (AEC) that can lead to tissue infiltration and damage. Idiopathic HES (iHES) comprises a subset of patients with HES, in which a reactive cause such as infections or an inflammatory process cannot be identified, and clonality is not demonstrable. iHES remains a challenge to treat since there is no specific mutation to target.
View Article and Find Full Text PDFBackground: Cough is a major symptom of asthma and is associated with poor clinical outcomes. However, current guidelines place little emphasis on the crucial relevance of the cough symptom and its treatment. The objective of this study was to assess the impact of dupilumab on chronic cough (CC) in patients with severe eosinophilic asthma (SEA) and chronic rhinosinusitis with nasal polyps (CRSwNP).
View Article and Find Full Text PDFJ Asthma Allergy
August 2025
Division of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
Allergic bronchopulmonary aspergillosis is characterized by hypersensitivity to spp. and often causes intractable asthma. Studies have been conducted on biologics administered to patients with allergic bronchopulmonary aspergillosis; however, treatment may not always be successful.
View Article and Find Full Text PDF