Eosinophilic Asthma: What You Need to Know

When it comes to asthma, there are different subtypes that require specific management approaches. One such subtype is eosinophilic asthma, a condition characterized by high levels of a type of white blood cell called eosinophils in the airways. Understanding the ins and outs of this condition is crucial as this inflammatory condition can significantly impact quality of life, necessitating specialized care and management.

While the journey with this condition can be fraught with challenges, there is a glimmer of hope on the horizon. Revival Research Institute is at the forefront of Asthma Research, conducting Clinical Trials, exploring potential new treatment options that may help improve the lives of asthmatics.

Continue reading to understand the symptoms, causes, diagnostic procedures and treatment options associated with this condition. This blog provides a comprehensive guide for those dealing with this condition.

Eosinophilic Asthma: What is it?

It is a severe form of asthma characterized by elevated levels of eosinophils, a type of white blood cell. Normally, eosinophils are vital to the immune system, helping to combat infections and target harmful bacteria. However, in individuals with EA, these cells trigger inflammation and swelling in the airways and respiratory system. The severity of asthma symptoms often correlates with the concentration of eosinophils in the blood.

It is estimated that this condition is rare as it is uncommon in the general population and affects only 5% of adults with asthma.

Difference in Symptoms of Eosinophilic Asthmatics

People with this condition commonly experience symptoms that are similar and slightly different than those with just asthma. The symptoms are as follows:

• Wheezing
• Persistent coughing
• Shortness of breath
• Chest tightness or discomfort
• Reduced lung function due to airflow obstruction
• Chronic sinusitis with nasal polyps
• Inflammation of the nasal lining
• Frequent respiratory infections
• Increased mucus production
• A decreased ability to exercise or engage in physical activity
• Difficulty sleeping due to coughing

Causes of Eosinophilic asthma

The exact cause of this condition is unknown but genetic and environmental factors are likely to play a role.

Genetics

Ongoing research continues to explore the genetic factors associated with eosinophilic asthma. Scientists have identified certain inherited gene mutations that may elevate the risk of developing this condition.

Alterations in genes responsible for regulating the production and function of eosinophils can lead to higher eosinophil levels in the bloodstream. These changes may cause an accumulation and activation of eosinophils in the airways, resulting in inflammation and an increased likelihood of this condition.

Environmental Triggers

Some individuals with this condition also suffer from conditions like eczema, hay fever, or food allergies, though this is not universal among all asthma patients. For those who do have allergies, certain environmental triggers can worsen the symptoms, including:

• Pollen
• Pet dander
• Dust mites
• Mold spores
• Lung irritants such as smoke or cleaning agents
• Intense physical activity
• Respiratory infections like the common cold or flu
• Extreme weather conditions
• Stress

These factors can either trigger or intensify the symptoms of this condition, making management more challenging.

Also Read: Does Asthma Go Away? Combat Indoor Allergens and Triggers

Eosinophilic Asthma: Diagnostic Procedures

If you have severe asthma or if your symptoms don’t improve with standard treatments, your healthcare provider may conduct tests to determine if eosinophilic asthma is the underlying cause. During your visit, your provider will evaluate your symptoms, review your medical history, and consider test results to make an accurate diagnosis. They may also order further tests to confirm the condition, including:

• Blood Test: This test measures the number of eosinophils circulating in your blood. Individuals with eosinophilic asthma typically have an eosinophil count of 150 cells or more per microliter of blood (cells/μl). Since other types of asthma can also lead to elevated eosinophil levels, your provider will assess your symptoms along with other test findings.
• Sputum Test: A sputum test involves collecting a mucus sample you’ve coughed up and examining it under a microscope to determine the percentage of eosinophils present. If you are unable to cough up mucus, your provider might have you inhale a saline solution via a nebulizer. In cases of eosinophilic asthma, over 2% of the cells in the sputum sample will be eosinophils.
• Bronchial Biopsy: A pulmonologist, who specializes in lung conditions, will use a bronchoscope, a thin flexible tube inserted through your nose or mouth to access your lungs. They will then collect a tissue or fluid sample for microscopic examination to check for eosinophils and signs of inflammation.

How Is Eosinophilic Asthma Treated and Managed?

In the United States, it is estimated that about 1 in 12 people have asthma. As medical professionals now recognize that asthma consists of various subtypes, they understand that each requires tailored treatments.

The primary objective of the treatment is to:

• Lower eosinophil levels in the airways
• Control inflammation
• Improve symptoms
• Reduce the frequency and severity of asthma attacks

While most people with this ailment respond to standard asthma therapies, many require additional biologic medications specifically targeting eosinophils or cytokines that regulate eosinophil growth and function.

Standard Asthma Treatments

The first line of treatment for this condition typically involves medications also used for other types of asthma. These include:

• Bronchodilators: These inhaled medications relax the muscles around the airways, helping to open them and reduce symptoms like coughing, chest tightness, and wheezing.
• Corticosteroids: These potent anti-inflammatory drugs help to reduce inflammation in the airways.
• Leukotriene Modifiers: These oral medications block leukotrienes, immune chemicals involved in the body’s allergic response. They help reduce airway swelling in people with this condition and allergies.

Biologics for Eosinophilic Asthma

In cases where traditional asthma treatments prove insufficient, biologic therapies may be recommended for managing this condition. These advanced treatments specifically target the biological pathways involved in the production and activity of eosinophils the white blood cells responsible for the inflammation seen in this type of asthma.

Biologics work by interfering with specific molecules that promote eosinophil growth and activation, thereby reducing inflammation in the airways. These therapies are typically administered through injections or intravenous infusions. In many cases, biologics are used alongside conventional asthma medications to provide comprehensive management of the condition.

By effectively reducing eosinophil levels, biologics can help decrease the frequency and severity of asthma attacks, improve overall lung function, and enhance the quality of life for those with this condition.

Also Read: Asthma Exacerbation Treatment & Management

Takeaway

Eosinophilic asthma is a complex respiratory condition characterized by elevated eosinophil levels in the airways, leading to inflammation and airway obstruction. While the exact cause remains unknown, genetic and environmental factors likely contribute to its development.

Effective management of this condition involves a tailored approach, often including a combination of traditional asthma medications and targeted biologic therapies. By understanding the unique characteristics of this condition and working closely with healthcare providers, individuals with this disease can improve their quality of life and manage symptoms effectively.