Eosinophilic Asthma

Abstract

Eosinophilic asthma is known as a main phenotype of asthma classified on the basis of immune cells involved in inflammatory response in the respiratory airway. Eosinophilic asthma can be related to increased severity of asthma, allergic sensitization, adult onset, and increased resistance to corticosteroids. The prevalence of eosinophilic asthma is 32-40% among asthmatic patients. Different cells and cytokines are involved in its pathogenesis including eosinophil, mast cells, type 2 helper T cells, innate lymphoid cells, IL-4, IL-5, and IL-13. Eosinophil count in induced sputum and bronchoalveolar lavage is the yardstick for recognizing and distinguishing eosinophilic asthma from non-eosinophilic asthma, while various tests which are noninvasive such as fractional exhaled nitric oxide and periostin are arising as possible substitutes. Novel and advanced therapies new and advanced therapies and more convenient biological drugs, Leads to high requirement for particular endotype-and phenotype-related treatment plans. Identification and knowledge of the specific pathophysiology of eosinophilic asthma have great association with disease management and chances for better patient prognosis.

Chemokines in allergic asthma inflammation

“…The Global Initiative for Asthma has classified asthma according to the frequency and severity of symptoms into intermittent, mild persistent, moderate persistent, and severe persistent asthma. (14,15) However, based on the underlying pathological mechanism, asthma is classified as type 2 and non-type 2 asthma. This classification is widely accepted because it is considered to reflect better the endotypes.…”

“…Activation of Th2-mediated immune responses and inflammatory cytokine generation are induced by IL-33. (14,23,24) Naive T cell stimulation requires costimulatory molecules such as CD28, inducible co-stimulator (ICOS), and OX40 with ligands that exist in DC (CD80/B7.1, CD86/B7.2, OX40 ligands, and ICOS ligands). Differentiation of T lymphocytes is also heavily influenced by the cytokine environment.…”

“…Th2 polarization implies high amounts of IL-4 and low levels of IL-12. (14) Activation of Th2 cells through the main transcription factor, namely GATA binding protein 3 (GATA3), induces the secretion of IL-5, IL-4, and IL-13 by these cells. IL-5 plays a role in the maturation and survival of eosinophils.…”

Ejercicio físico como posible tratamiento de apoyo no farmacológico para pacientes con asma grave no alérgica

“…El asma es una enfermedad crónica con una alta frecuencia entre la población, afectando a más de 300 millones de personas en el mundo generando síntomas respiratorios, limitaciones en las actividades, y exacerbaciones que requieren de un tratamiento médico avanzado o asistencia hospitalaria (Global Initiative for Asthma, 2019). Los factores de riesgo asociados a esta patología son la exposición a alérgenos como los ácaros de polvo, polen, sustancias procedentes de animales domésticos y moho; y por otro lado, la exposición a químicos industriales, infecciones y algunos fármacos (Global Initiative for Asthma, 2019); (Mubarak, Shakoor, & Masood, 2019).…”