Eosinophils and eosinophil-associated disorders: immunological, clinical, and molecular complexity

Peter Valent*, Lina Degenfeld-Schonburg, Irina Sadovnik, Hans Peter Horny, Michel Arock, Hans Uwe Simon, Andreas Reiter, Bruce S. Bochner

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Eosinophils and their mediators play a crucial role in various reactive states such as bacterial and viral infections, chronic inflammatory disorders, and certain hematologic malignancies. Depending on the underlying pathology, molecular defect(s), and the cytokine- and mediator-cascades involved, peripheral blood and tissue hypereosinophilia (HE) may develop and may lead to organ dysfunction or even organ damage which usually leads to the diagnosis of a HE syndrome (HES). In some of these patients, the etiology and impact of HE remain unclear. These patients are diagnosed with idiopathic HE. In other patients, HES is diagnosed but the etiology remains unknown — these patients are classified as idiopathic HES. For patients with HES, early therapeutic application of agents reducing eosinophil counts is usually effective in avoiding irreversible organ damage. Therefore, it is important to systematically explore various diagnostic markers and to correctly identify the disease elicitors and etiology. Depending on the presence and type of underlying disease, HES are classified into primary (clonal) HES, reactive HES, and idiopathic HES. In most of these patients, effective therapies can be administered. The current article provides an overview of the pathogenesis of eosinophil-associated disorders, with special emphasis on the molecular, immunological, and clinical complexity of HE and HES. In addition, diagnostic criteria and the classification of eosinophil disorders are reviewed in light of new developments in the field.

Original languageEnglish (US)
Pages (from-to)423-438
Number of pages16
JournalSeminars in Immunopathology
Volume43
Issue number3
DOIs
StatePublished - Jun 2021

Keywords

  • Classification
  • Eosinophilic leukemia
  • FIP1L1-PDGFRA
  • Hypereosinophilia
  • Hypereosinophilic Syndromes
  • Targeted therapy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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