Eosinophil-associated diseases: the allergist’s and clinical immunologist’s perspective

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Authors Information

1UO Pneumology ASST Rhodense, Garbagnate Milanese Hospital, Milan, Italy
2Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, Pavia, Italy
3First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
4National PhD Course in Precision Medicine in Rare Diseases, University of Palermo, Palermo, Italy
5Clinica Medica, Department of Internal Medicine, Marche University Hospital, Ancona, Italy
6Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Italy
7Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy 


Published: 28 March 2024
Accepted: 27 March 2024
Received: 12 February 2024


Eosinophil-associated diseases (EADs) refer to heterogeneous conditions in which eosinophils are believed to play critical pathological roles. They encompass common respiratory conditions, such as asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), less common primary eosinophilic disorders of gastrointestinal tract, and rare conditions including eosinophilic granulomatosis with polyangiitis (EGPA) and hypereosinophilic syndrome (HES). A literature search was carried out in January 2024 in the MEDLINE and Scopus databases using the PubMed search engine (PubMed, National Library of Medicine, Bethesda, MD). We focused on blood eosinophilia and hypereosinophilia. A diagnostic workup is proposed. From allergist’s point of view, we focused the review on 4 groups of eosinophilic disorders of specific interest. Our increased understanding of type 2 inflammation and biology has recently led to development of highly effective precision targeted therapies that are now approved for a growing number of eosinophilic disorders. Novel targeted biologics have a major impact on treatment strategies and have resulted in major advances in our understanding of the pathogenesis of these disorders. In the context of EADs, according to the heterogeneity of eosinophilic disorders a multidisciplinary approach should be adopted. Allergists and Clinical Immunologists play an important role as they have a clear understanding of the eosinophilic inflammation and the role of cytokines and are trained to recognize and characterize type 2 (T2) inflammation and its associated pathologies.

Eosinophilia; hypereosinophilia; eosinophilic disorders of gastrointestinal tract (EGID); eosinophilic granulomatosis with polyangiitis (EGPA); hypereosinophilic syndrome (HES).

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European Annals of Allergy and Clinical Immunology ISSN 1764-1489 | © 2024