Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 28;13(3):754.
doi: 10.3390/jcm13030754.

Eosinophilic Patterns in Patients with Seasonal Allergy Affected by Bronchial Asthma and Rhinitis/Rhinosinusitis: Efficacy of Benralizumab in Patients with the Persistent Pattern

Valentina D'Aiuto  1 , Ilaria Mormile  1 , Francescopaolo Granata  1 , Antonio Romano  2 , Francesca Della Casa  1 , Caterina D'Onofrio  3 , Valentina Marzio  3 , Gabriele Mignogna  3 , Luigi Califano  2 , Amato de Paulis  1   4 , Francesca Wanda Rossi  1   4
Affiliations

Eosinophilic Patterns in Patients with Seasonal Allergy Affected by Bronchial Asthma and Rhinitis/Rhinosinusitis: Efficacy of Benralizumab in Patients with the Persistent Pattern

Valentina D'Aiuto et al. J Clin Med. .

Abstract

Background: Eosinophilia can be influenced by multiple factors. This study aims to set a protocol for monitoring blood absolute eosinophil count (AEC) in patients with seasonal allergy affected by bronchial asthma (BA), allergic rhinitis (AR), or chronic rhinosinusitis with or without nasal polyposis (CRSw/sNP).

Methods: We planned a total of four annual blood samples to measure AEC in- and out-seasonal pollen exposure (i.e., one measurement every three months for one year).

Results: We identified two distinct groups of patients (non-eosinophilic and eosinophilic). Patients in the eosinophilic group presented with four different patterns (episodic, transient, floating, and persistent). Most patients with episodic, transient, and floating patterns were affected by mild allergy and the increase in eosinophils was related to allergen exposure. In contrast, patients with the persistent pattern mostly presented with more severe allergy (i.e., severe BA and relapsing CRSwNP) and the eosinophilia was unrelated to allergen exposure. The subgroup of patients with severe BA, relapsing CRSwNP, and persistent eosinophilc pattern were treated with benralizumab, which induced a noteworthy improvement in both severe BA and CRSwNP.

Conclusions: Multiple AEC measurements in patients with seasonal allergy can better reflect patient's eosinophilic status and help define the relationship of AEC enhancement with allergen exposure.

Keywords: allergic rhinitis; asthma; benralizumab; chronic rhinosinusitis; chronic rhinosinusitis with nasal polyposis; eosinophils; interleukin-5.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 3
Figure 3
Stratification of patients in the eosinophilic group based on AEC variations and allergen exposure: (A) episodic pattern (n = 18); (B) transient pattern (n = 9); (C) floating pattern (n = 5); persistent pattern (D). See text for description of pattern characteristics.
Figure 1
Figure 1
Absolute peripheral eosinophil count (AEC) in the 4 blood samples collected in the different seasons: (A) non-eosinophilic patients (n = 36); (B) eosinophilic patients (n = 42). * p < 0.05; ** p < 0.01.
Figure 2
Figure 2
Stratification of eosinophilic (n = 42) and non-eosinophilic (n = 36) patients in categories according to medium AEC (MAEC) (A). Percentage of patients underestimated (step-down category of MAEC) or overestimated (step-up of category of MAEC) if a single determination of AEC (i.e., the minimum or the maximum registered value) had been considered (B).
Figure 4
Figure 4
Exacerbation rate (A) and eosinophil count (B) in our cohort of patients treated with benralizumab. * p < 0.05.
Figure 5
Figure 5
Clinical asthma outcomes (Asthma Control Test (ACT), panel (A) and VAS Asthma Symptoms, panel (B)) in our cohort of patients treated with benralizumab. * p < 0.01, ** p < 0.05.
Figure 6
Figure 6
Pulmonary function tests (FEV1, panel (A) and (B) and FEV1/FVC, panel (C) and (D)) in our cohort of patients treated with benralizumab. * p < 0.01, ** p < 0.05.
Figure 7
Figure 7
Rhino-nasal outcomes (Sinonasal Outcome Test (SNOT)-22 and Chronic Rhinosinusitis Visual Analog Scale (VAS CRS) Symptoms, panel (A); Nasal Polyp Score (NPS) Total, panel (B)) in our cohort of patients treated with benralizumab. * p < 0.01, ** p < 0.05.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Rosenberg H.F., Dyer K.D., Foster P.S. Eosinophils: Changing perspectives in health and disease. Nat. Rev. Immunol. 2013;13:9–22. doi: 10.1038/nri3341. - DOI - PMC - PubMed
    1. Blanchard C., Rothenberg M.E. Biology of the eosinophil. Adv. Immunol. 2009;101:81–121. doi: 10.1016/S0065-2776(08)01003-1. - DOI - PMC - PubMed
    1. Hogan S.P., Rosenberg H.F., Moqbel R., Phipps S., Foster P.S., Lacy P., Kay A.B., Rothenberg M.E. Eosinophils: Biological properties and role in health and disease. Clin. Exp. Allergy. 2008;38:709–750. doi: 10.1111/j.1365-2222.2008.02958.x. - DOI - PubMed
    1. Maniscalco M., Fuschillo S., Mormile I., Detoraki A., Sarnelli G., Paulis A., Spadaro G., Cantone E., Path-2 Task F. Exhaled Nitric Oxide as Biomarker of Type 2 Diseases. Cells. 2023;12:2518. doi: 10.3390/cells12212518. - DOI - PMC - PubMed
    1. Rosenberg H.F., Dyer K.D., Domachowske J.B. Respiratory viruses and eosinophils: Exploring the connections. Antiviral. Res. 2009;83:1–9. doi: 10.1016/j.antiviral.2009.04.005. - DOI - PMC - PubMed

Grants and funding

This research received no external funding.
-