Eosinophilic Lung Disease Pathogenesis and Management
Summary
Eosinophilic lung diseases encompass a spectrum of disorders characterised by the accumulation of eosinophils within pulmonary tissues and airspaces. Pathogenesis is driven by dysregulated type 2 immune responses in which interleukin-5 and other cytokines promote eosinophil maturation, survival and recruitment. Chemokines such as eotaxin-2 and CCL13 guide eosinophil transmigration across endothelium, while lipid mediators and damage-associated molecular patterns amplify local inflammation. Clinically, presentations range from acute eosinophilic pneumonia (rapid onset with respiratory failure) to chronic eosinophilic pneumonia (insidious breathlessness and constitutional symptoms). Diagnosis relies on imaging showing peripheral or bilateral opacities, elevated eosinophil counts in blood or bronchoalveolar lavage, and exclusion of secondary causes including drug toxicity, infection and vasculitis. Management pivots on removing inciting factors and systemic corticosteroids, which often induce rapid remission. However, relapses are frequent in chronic forms, prompting investigation of targeted therapies such as anti-IL-5 monoclonal antibodies. Recent advances have elucidated risk factors for drug-induced disease, refined diagnostic algorithms and begun to translate mechanistic insights into biomarker-guided interventions. Ongoing challenges include optimising long-term control, minimising steroid exposure and integrating novel biologics into treatment pathways to improve patient outcomes globally.
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Eosinophilic Lung Disease Pathogenesis and Management publication trend
The graph below shows the total number of articles in eosinophilic lung disease pathogenesis and management across all publications each year (not limited to Nature Index journals).
Technical terms
Eosinophil: A granulocytic white blood cell that participates in allergic inflammation and host defence against parasites.
Bronchoalveolar lavage (BAL): A diagnostic procedure in which fluid is instilled into and retrieved from the lower respiratory tract to analyse cellular and soluble components.
Acute eosinophilic pneumonia (AEP): A fulminant form of eosinophilic lung disease characterised by rapid respiratory compromise and high pulmonary eosinophil counts.
Chronic eosinophilic pneumonia (CEP): A more indolent variant presenting with gradual onset of respiratory and systemic symptoms alongside persistent eosinophilia.
Interleukin-5 (IL-5): A cytokine central to eosinophil differentiation, activation and survival, and a key therapeutic target.
Chemokine: A small secreted protein that directs the migration of immune cells through interaction with specific receptors.
References
- Daptomycin eosinophilic pneumonia, a systematic review of the literature and case series. Infection (2024).
- Risk Factors of Daptomycin-Induced Eosinophilic Pneumonia in a Population with Osteoarticular Infection. Antibiotics (2021).
- Possible Mechanisms of Eosinophil Accumulation in Eosinophilic Pneumonia. Biomolecules (2020).
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