Eosinophil Biomarkers in Allergic Asthma Management
Summary
Allergic asthma is characterised by type 2 inflammation driven in large part by eosinophils, specialised white blood cells that contribute to airway hyperresponsiveness, mucus overproduction and tissue remodelling. Reliable biomarkers of eosinophil activation and degranulation have become indispensable for stratifying patients, predicting exacerbations and guiding targeted therapies. Traditionally, peripheral blood eosinophil count and the fraction of exhaled nitric oxide have served as accessible proxies for eosinophilic airway inflammation. More recently, measurement of eosinophil‐derived proteins—such as eosinophil‐derived neurotoxin (EDN), eosinophil cationic protein (ECP) and urinary eosinophil protein X (uEPX)—has added specificity and sensitivity to the assessment of disease activity. These biomarkers correlate with clinical severity, lung function decline and response to biologic agents against interleukin-5 and its receptor. Integration of these measures into routine practice supports precision medicine approaches, enabling clinicians to escalate or de-escalate therapy appropriately, reduce oral corticosteroid exposure and improve long-term outcomes. Globally, the adoption of eosinophil biomarkers promises to harmonise clinical trials, refine guideline recommendations and foster equitable access to advanced treatments across diverse healthcare settings.
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Eosinophil Biomarkers in Allergic Asthma Management publication trend
The graph below shows the total number of articles in eosinophil biomarkers in allergic asthma management across all publications each year (not limited to Nature Index journals).
Technical terms
Biomarker: A measurable indicator of biological or pathogenic processes, used to diagnose or monitor disease and guide therapy.
Eosinophils: A subtype of granulocytic white blood cell involved in allergic inflammation and parasitic defence.
Eosinophil‐derived neurotoxin (EDN): A ribonuclease released by activated eosinophils, reflecting degranulation and airway inflammation.
Eosinophil cationic protein (ECP): A cytotoxic protein stored in eosinophil granules, released upon activation and associated with tissue damage.
Urinary eosinophil protein X (uEPX): A stable fragment of ECP excreted in urine, used as a non-invasive marker of systemic eosinophil activation.
Airway hyperresponsiveness (AHR): Exaggerated bronchoconstrictive response to stimuli, characteristic of asthma pathophysiology.
References
- The Role of Eosinophil-Derived Neurotoxin and Vascular Endothelial Growth Factor in the Pathogenesis of Eosinophilic Asthma. Cells (2023).
- Eosinophil‐derived neurotoxin levels in early childhood and association with preschool asthma – A prospective observational study. Clinical & Experimental Allergy (2023).
- Eosinophil-derived neurotoxin: A biologically and analytically attractive asthma biomarker. PLOS ONE (2021).
- Clinical Potential of Eosinophil-Derived Neurotoxin in Asthma Management. The Journal of Allergy and Clinical Immunology In Practice (2022).
- Update on Clinical Inflammometry for the Management of Airway Diseases. Canadian Respiratory Journal (2013).
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