Chronic rhinosinusitis: Eosinophil blood reference values and decision limits and tissue count intravariability

Yang, Baoran; Dziadzio, Magdalena; Meridamorillas, Marta; Joseph, Jonathan A; Gane, Simon; James, Louisa K.; Kariyawasam, Harsha H.

doi:10.1111/coa.13793

Cited by 1 publication

(1 citation statement)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High IL-5 endotypes almost exclusively have a CRSwNP phenotype and a high prevalence of associated eosinophilic asthma of over 70% [1 ]. A blood eosinophil count as low as 0.28 Â 10 9 l was able to identify the coexistence of CRSwNP and asthma in the context of the airway history [8]. High IL-5 concentrations are established and maintained by not just Th2 CD4 þ and CD8 þ T cells [9] but also mast cells, basophils [10] and B cells [11], ILC2s [12] and the extensive, highly activated epithelium [13].…”

Section: Interleukin-5 Endotypesmentioning

confidence: 99%

Chronic rhinosinusitis with nasal polyps: eosinophils versus B lymphocytes in disease pathogenesis

Kariyawasam,

James

2023

Current Opinion in Allergy &Amp; Clinical Immunology

Self Cite

View full text Add to dashboard Cite

Purpose of review To highlight the current evidence that supports the view that eosinophils may not drive disease in chronic rhinosinusitis with nasal polyps (CRSwNP) and the emerging evidence for B cells as an important player in this disease. Recent findings Eosinophil depletion studies in CRSwNP do not fully support a critical role for eosinophils in CRSwNP. Almost complete eosinophil depletion with dexpramipexole had no impact on polyp size reduction or clinical improvement. Anti-interleukin (IL)-5 and IL-5Rα inhibition were more effective though with less clinical impact when compared to anti-immunoglobulin E (IgE) or IL-4Rα inhibition strategies. As IL-5Rα is also expressed on CRSwNP derived IgE+ and IgG4+ plasma cells to the same extent as eosinophils, improvements in CRSwNP with IL-5 inhibition may suggest a role for B cells over eosinophils in CRSwNP. We review both eosinophils and B cells in the context of CRSwNP and highlight the current evidence that supports an emerging role for B cells. Summary Despite many aspects of immunopathology in CRSwNP explainable by B cell dysfunction, B cells have so far been ignored in CRSwNP. Further work is needed, as targeting B cells may offer an exciting new therapeutic option in the future.

show abstract