This review highlights recent advances in the understanding of eosinophils and eosinophilic
diseases, particularly eosinophilic gastrointestinal diseases during the last year.
The increasing incidence of diseases marked by eosinophilia has been documented and
highlighted the need to understand eosinophil biology and eosinophilic contributions
to disease. Significant insight into the nature of eosinophilic diseases has been
achieved using next-generation sequencing technologies, proteomic analysis, and machine
learning to analyze tissue biopsies. These technologies have elucidated mechanistic
underpinnings of eosinophilic inflammation, delineated patient endotypes, and identified
patient responses to therapeutic intervention. Importantly, recent clinical studies
using monoclonal antibodies that interfere with type 2 cytokine signaling or deplete
eosinophils point to multiple and complex roles of eosinophils in tissues. Several
studies identified distinct activation features of eosinophils in different tissues
and disease states. The confluence of these studies supports a new paradigm of tissue-resident
eosinophils that have pro- and anti-inflammatory immunomodulatory roles in allergic
disease. Improved understanding of unique eosinophil activation states is now poised
to identify novel therapeutic targets for eosinophilic diseases.
BZH (Basal zone hyperplasia), CD (Cluster of differentiation), ChIP (Chromatin immunoprecipitation), CLC (Charcot-Leyden crystals), CRSsNP (Chronic rhinosinusitis without nasal polyps), CRSwNP (Chronic rhinosinusitis with nasal polyps), EGID (Eosinophilic gastrointestinal diseases), EoC (Eosinophilic colitis), EoC (Eosinophilic duodenitis), EoE (Eosinophilic esophagitis), FDA (Food and drug administration), GWAS (Genome wide association studies), HES (Hypereosinophilic syndrome), IgE (Immunoglobulin E), IL (Interleukin), ILC (Innate lymphoid cell type), MCTR (Maresin conjugates in tissue regeneration), miR-1 (microRNA 1), PPI (Proton pump inhibitor), ROC (Receiver operating characteristic), RNAseq (Ribonucleic acid sequencing), scRNAseq (Single cell ribonucleic acid sequencing), STING (Stimulator of interferon genes), TSLP (Thymic stromal lymphopoietin)
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M.E.R. is a consultant for Pulm One, Spoon Guru, ClostraBio, Serpin Pharm, Allakos, Celgene, Astra Zeneca, Adare/Ellodi Pharma, GlaxoSmithKline, Regeneron/Sanofi, Revolo Biotherapeutics, Celldex and Guidepoint and has an equity interest in the first five listed, and royalties from reslizumab (Teva Pharmaceuticals). PEESSv2 (Mapi Research Trust) and UpToDate. M.E.R. is an inventor of patents owned by Cincinnati Children’s Hospital. J.L.M.D. has no financial interests to disclose.
© 2021 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.