Human eosinophils exert antitumorigenic effects on chordoma

In many cases, the diagnosis of eosinophilic myocarditis is suggested by an elevated peripheral blood eosinophil count. However, no detailed studies have been performed on the sequential changes in the initial peripheral blood eosinophil count over the course of the disease. We measured the peripheral blood eosinophil count at the time of presentation in eight patients with eosinophilic myocarditis proven by endomyocardial biopsy and intermittently thereafter. The eosinophil count at the time of onset was <500/mm(3) in four patients, >500/mm(3) but <1,000/mm(3) in three patients, and > or =1,000/mm(3) in one patient. In three of the four patients with an initial eosinophil count of <500/mm(3), an increase to > or =500/mm(3) occurred 7-12 days after the onset. The remaining patient did not develop peripheral eosinophilia. In conclusion, in the early stage of eosinophilic myocarditis, peripheral hypereosinophilia is not present initially in some patients, and may not develop during the course of the illness in a subset of these patients.

The initial peripheral eosinophil count (PEC) is rarely elevated but tends to increase during the clinical course of acute eosinophilic pneumonia (AEP). We evaluated whether initial peripheral eosinophilia is an indicator of mild disease in patients with AEP. We retrospectively examined associations between initial peripheral absolute eosinophil count, inflammatory markers and clinical characteristics in 85 patients with AEP. Of 85 patients, 24 (28%) had initial peripheral eosinophilia (>500/μL). Initial peripheral absolute eosinophil count was inversely correlated to white blood cell (WBC) count (ρ = -0.386, P < 0.001), neutrophil percentage (ρ = -0.645, P < 0.001) and C-reactive protein (CRP; ρ = -0.495, P < 0.001). During treatment, peripheral absolute eosinophil counts increased, while inflammatory markers (WBC, neutrophil percentage, and CRP) decreased. Patients with initial peripheral eosinophilia had a longer duration from onset of symptoms to admission (P = 0.006), had lower WBC counts, neutrophil percentages and CRP values (all P < 0.001), and higher oxygen saturation (P = 0.004) than patients with normal peripheral eosinophil counts. Oxygen requirements (P = 0.013), duration of oxygen administration (P = 0.028) and intensive care unit admission rates (P = 0.003) were lower in patients with initial peripheral eosinophilia. All patients survived and recovered fully after corticosteroid or conservative treatment. Initial PEC may be related to a milder disease status on admission, compared with normal PEC in patients with AEP. This may help to stratify disease severity in AEP.

Significance of the eosinophil cationic protein/eosinophil count ratio in asthmatic patients: its relationship to disease severity.

PurposeEosinopenia has been described in COVID-19. With this study, we aim to study the peripheral blood eosinophil counts in COVID-19 patients and to investigate whether there is an association between the peripheral blood eosinophil counts and disease severity of COVID-19.MethodsWe revised the electronical medical records of confirmed COVID-19 patients with polymerase chain reaction (PCR) assays in the Groene Hart Ziekenhuis, Gouda, The Netherlands. We divided patients in mild, moderate and severe groups based on clinical severity of COVID-19. Clinical severity was based on the therapy needed and the outcome of patients. We compared clinical characteristics, laboratory results and outcome between the three groups.ResultsOf the 230 patients included in this study, the mild, moderate and severe groups consisted of 16.5%, 45.7% and 37.8% of the included patients, respectively. The mean age was 68 years (IQR 57–78). 63% of patients were male. A significant decrease in the peripheral eosinophil counts was found corresponding to the increase of COVID-19 severity. In the mild, moderate and severe groups, the percentage of patients with eosinopenia was 73.7%, 86.7% and 94.3%, respectively (p value 0.002).ConclusionEosinopenia is significantly more frequent present in patients with a severe COVID-19.

Lung cancer is the leading cause of cancer-related death globally and is often diagnosed at an advanced stage. Nivolumab represents a significant advancement for treating advanced non-small cell lung cancer (NSCLC). However, the absence of reliable biomarkers predicting treatment response hinders personalized therapy. Eosinophils play a notable role in cancer biology, particularly when treated with immune checkpoint inhibitors. Eosinophils can infiltrate tumor tissues, directly interacting with tumor cells or modifying the tumor microenvironment. This study aims to assess the potential of PD-L1 expression and peripheral blood eosinophil count in predicting treatment response and patient survival. This retrospective cohort study was conducted in three major cancer centers in Turkey, including 174 advanced NSCLC patients who had progressed after chemotherapy between July 2019 and November 2023. Demographic and clinical data, PD-L1 levels, and eosinophil counts were analyzed using SPSS 27.0. Survival analyses were performed with Kaplan-Meier and Cox regression models. Increased peripheral blood eosinophil count was positively associated with response to Nivolumab treatment and overall survival. Among treatment responders, 54.1% had eosinophil levels between 100-499 cells/mm3 before treatment, increasing to 70.8% post-treatment. In patients with high PD-L1 positivity (>50%), eosinophil levels averaged 266.0 cells/mm3, with improved survival outcomes (mean survival: 24.06 months, median: 20.0 months). Non-responders had a mean survival of 19.05 months and a median survival of 15.2 months. Peripheral eosinophil count appears to be a potential biomarker for predicting response to Nivolumab treatment and survival in NSCLC patients. Combined evaluation of eosinophil count and PD-L1 expression may enhance personalized treatment strategies. Further validation in prospective, randomized studies is necessary.

Eosinophils and Pulmonary Function: an Epidemiologic Study of Adolescents and Young Adults

Increased levels of serum pro-fibrotic cytokines have been reported in patients with systemic sclerosis (SSc). Some of these cytokines also play an important role in the differentiation and migration of eosinophils. The aim of this study was to determine whether eosinophilic inflammation is caused in SSc. We retrospectively reviewed the peripheral blood eosinophil counts in 70 untreated patients with SSc and compared them with those in patients with other major collagen diseases. We additionally evaluated a possible association with disease severity. Eosinophil counts were significantly higher levels in patients with SSc than in those with other collagen diseases, whereas total leukocyte counts were not. Eosinophil counts correlated positively with both severe interstitial lung disease (ILD; r = 0.255, p = 0.033) and modified Rodnan total skin thickness score (m-Rodnan TSS) in SSc (r = 0.347, p = 0.003), but did not correlate with ILD severity in other collagen diseases. In conclusion, peripheral eosinophil counts were higher in patients with SSc than in those with other collagen diseases and were correlated with increased disease severity. Our data suggest that eosinophilic inflammation is involved in the pathogenesis and progression of SSc.

Simple SummaryCanine atopic dermatitis (AD) is a common allergic skin disease that often causes itching and discomfort in dogs, leading to reduced quality of life. To better understand the usefulness of blood-based tests in dogs with AD, we examined eosinophil counts, serum allergen-specific immunoglobulin E (IgE), and several cytokines related to allergy and immune regulation. Ninety-three dogs were enrolled, including 65 diagnosed with AD and 28 healthy controls. We found that eosinophil counts were not significantly different between affected and healthy dogs, suggesting limited diagnostic value. However, allergen-specific IgE testing showed higher levels and sensitization rates to several common environmental and food allergens, particularly house dust and storage mites, pollens, and certain dietary ingredients. Cytokine levels showed some trends but were not significantly different. Our results indicate that allergen-specific IgE testing can provide meaningful information for diagnosis and management of AD in dogs.Canine atopic dermatitis (AD) is a chronic allergic skin disease in which various immunological markers have been investigated. While peripheral eosinophil counts, serum allergen-specific immunoglobulin E (IgE), and cytokines have each been evaluated in allergic disorders, their simultaneous assessment in dogs with AD has rarely been reported in Korea. This study aimed to evaluate the diagnostic and clinical utility of these parameters in affected dogs. A total of 93 dogs were included between August 2019 and February 2020, comprising 65 dogs diagnosed with AD and 28 healthy controls. Clinical information, peripheral blood eosinophil counts and ratios, serum allergen-specific IgE using a multiple allergen panel (60 allergens), and cytokines related to T helper 2 (Th2) and T regulatory (Treg) cells (IL-4, IL-13, IL-31, TGF-β1) were analyzed. The mean age of AD dogs was 6.34 ± 3.99 years, with a predominance of small breeds and males. Eosinophil counts and ratios showed no significant difference between groups. In contrast, allergen-specific IgE levels were significantly elevated for several allergens, including Dermatophagoides pteronyssinus, Acarus siro, Tyrophagus putrescentiae, alder/birch, hazel, oak, cladosporium, and selected dietary antigens (pea, soybean, pumpkin, apple) (p < 0.05). Sensitization rates were also higher for Acarus siro, Tyrophagus putrescentiae, oak, and sheep sorrel (p < 0.05). Th2-related cytokines tended to increase and TGF-β1 tended to decrease in AD dogs, though without statistical significance. These findings indicate that peripheral eosinophil counts have limited diagnostic value, whereas allergen-specific IgE testing provides clinically useful information for the diagnosis and management of canine AD. Further research stratifying disease stages and assessing local tissue cytokine expression is warranted.

Background and objectivesGenome-wide association studies identified single-nucleotide polymorphisms (SNPs) at the 17q21 locus conferring increased risk for childhood-onset asthma. Little is known about how these SNPs impact adult asthma patients. We sought to examine an adult population for associations between rs7216389 (17q21-associated SNP) and features of asthma including fractional exhaled nitric oxide (FeNO), eosinophil counts, and age of asthma onset.MethodsSubjects were genotyped at SNP rs7216389. The geometric mean of FeNO measurements and peripheral blood eosinophil counts from 2008 to 2015 were collected. Demographics and medical history were collected including self-reported allergy diagnoses and age of asthma onset. Eosinophils, monocytes, and peripheral blood mononuclear cells (PBMCs) were isolated for the examination of ORMDL3 expression.ResultsFeNO levels from 157 genotyped subjects (31CC, 72CT, and 54TT) and peripheral eosinophil counts from 252 genotyped subjects (46CC, 122CT, and 84TT) were analyzed. In a sub-group analysis of asthma subjects, the number of attributable T alleles was associated with significantly lower age of asthma onset (P=0.03) and greater FeNO levels (geometric mean 30.0 ppb TT, 20.0 ppb CT, 20.0 ppb CC, P=0.02). In the total cohort of subjects, the T allele was associated with a higher percentage of individual eosinophil counts >200/mm3 (45% TT, 26% CT, 24% CC, P=0.005). Eosinophils expressed ORMDL3 mRNA and protein.ConclusionIn adult subjects, the number of T alleles at SNP rs7216389 corresponds to significantly greater FeNO levels and peripheral eosinophil counts. The expression of ORMDL3 in eosinophils suggests that they may participate in mediating the asthma risk associated with the 17q21 locus.

Background: European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2020 proposed a novel primary chronic rhinosinusitis (CRS) phenotype classification. As the endotype and phenotype of primary CRS are highly heterogeneous, clinical evaluation to match these endotypes and corresponding clinical biomarkers with these novel phenotypes is still limited. This study aimed to evaluate the correlation between clinical inflammatory biomarkers and primary CRS phenotype. Materials and Methods: A retrospective study of 78 adult patients diagnosed with primary CRS was conducted. Peripheral eosinophil count, serum-specific immunoglobulin E (ssIgE), and primary CRS phenotyping data were collected from the electronic health record database of Dr. Kariadi General Hospital Semarang. The Chi-square test and phi coefficient were used to assess the correlation between variables. Results: Most patients have polysensitization allergen patterns, predominated by house dust mites (Tyrophagus putrescentiae, Dermatophagoides microceras, and Dermatophagoides farinae) and grass pollens (Bermuda grass,mix grass, and Timothy grass). peripheral eosinophil count and ssIgE are significantly correlated to primary CRS phenotype (r=+0.407, p 0.001; r=+0.342, p=0.002; respectively). We also found a small portion of some peculiar conditional probabilities of having non-eCRS given patients have peripheral eosinophilia and positive ssIgE (6.2% and 17.3%, respectively). Conclusion: peripheral eosinophils count and ssIgE are correlate to the CRS phenotype.

Montelukast is a cysteinyl leukotriene receptor antagonist used to treat persistent asthma in patients aged > or = 6 years. The drug has a rapid onset of action. Improvements in lung function and reductions in as-needed beta2-agonist usage are apparent within 1 day of initiating montelukast treatment in adults and adolescents (aged > or = 15 years treated with 10 mg/day) or children (aged 6 to 14 years treated with 5 mg/day) with persistent asthma as shown in clinical trials. In two 12-week, multicentre, randomised, double-blind studies in adults and adolescents aged > or = 15 years with persistent asthma [forced expiratory volume in 1 second (FEV1) = 50 to 85% predicted] there was significantly (p < 0.05) greater improvement in FEV1, symptom scores, peak expiratory flow (PEF), as-needed beta2-agonist use, peripheral eosinophil counts and health-related quality of life (QOL) in patients treated with montelukast 10 mg/day than in recipients of placebo. Improvements were significantly greater in patients treated with inhaled beclomethasone 400 microg/day than in recipients of montelukast 10 mg/day in 1 of these studies. Nonetheless, 42% of montelukast recipients experienced > or = 11% improvement in FEV1, the median improvement in this parameter in beclomethasone-treated patients. In an 8-week multicentre, randomised, double-blind, study in children aged 6 to 14 years with persistent asthma (FEV1 50 to 85% predicted), montelukast 5 mg/day produced significantly greater improvements in FEV1, clinic PEF, as-needed beta2-agonist use, peripheral eosinophil counts, asthma exacerbations and QOL scores than placebo. The combination of montelukast 10 mg/day plus inhaled beclomethasone 200 microg twice daily provided significantly better asthma control than inhaled beclomethasone 200 microg twice daily in adults with poorly controlled asthma (mean FEV1 = 72% predicted) despite 4 weeks treatment with inhaled beclomethasone. Patients receiving the combination experienced significant improvements in FEV1 and morning PEF, significant reductions in daytime symptom scores, as-needed beta2 agonist usage and night-time awakenings with asthma, and had significantly lower peripheral blood eosinophil counts after 16 weeks in this multicentre, randomised, double-blind, placebo-controlled study. Among adults (FEV1 > or = 70%) treated with montelukast 10 mg/day for 12 weeks, inhaled corticosteroid dosages were titrated downward by 47% (vs 30% in placebo recipients), 40% of patients were tapered off of inhaled corticosteroids (vs 29%), and significantly fewer patients (16 vs 30%) experienced failed corticosteroid rescues in a multicentre, randomised, double-blind study. During clinical studies, the frequency of adverse events in montelukast-treated adults, adolescents and children was similar to that in placebo recipients. In conclusion, montelukast is well tolerated and effective in adults and children aged > or = 6 years with persistent asthma including those with exercise-induced bronchoconstriction and/or aspirin sensitivity. Furthermore, montelukast has glucocorticoid sparing properties. Hence, montelukast, as monotherapy in patients with mild persistent asthma, or as an adjunct to inhaled corticosteroids is useful across a broad spectrum of patients with persistent asthma.

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Cervical cancer poses a significant global health burden, particularly in its metastatic and recurrent forms, for which treatment options are limited. Although immune checkpoint inhibitors (ICIs) such as pembrolizumab have improved outcomes, predictive markers for efficacy are still undefined. This retrospective study investigated changes in peripheral blood eosinophil and lymphocyte counts as potential prognostic indicators in patients with metastatic or recurrent cervical cancer undergoing pembrolizumab-based therapy. Forty-one patients treated with pembrolizumab plus taxane-platinum chemotherapy (± bevacizumab) were analyzed. Peripheral blood eosinophil and lymphocyte counts were measured before and 3 weeks after treatment initiation. Statistical analyses included Kaplan-Meier curves, Cox regression, and log-rank tests. Immune-related adverse events ≥ grade 2 emerged as a significant independent factor associated with prolonged progression-free survival (PFS) in this cohort (p = 0.014). Patients with decreased eosinophil count ratios post-treatment demonstrated longer PFS, particularly among those with recurrence and those who had received prior radiotherapy (p = 0.0001). Conversely, increased lymphocyte count ratios correlated with improved PFS in patients undergoing primary treatment (p = 0.018). Changes in peripheral eosinophil and lymphocyte counts following pembrolizumab initiation may serve as predictive indicators of treatment efficacy in specific cervical cancer subgroups. Incorporating these hematologic parameters could help optimize patient selection and therapeutic strategies. Further research is needed to clarify their role as predictive markers of pembrolizumab efficacy in cervical cancer.

Background The phenomenon of eosinophilic myocarditis in explanted hearts was first reported in a series in 1991. The phenomenon remains under-recognised and the incidence uncertain, current published estimates ranging widely from 7 to 22%. Aims We sought to ascertain the incidence of eosinophilic myocarditis in our transplant centre and to assess if presence of an eosinophilic infiltrate was associated with dobutamine therapy prior to explant. Methods 76 sequential heart transplant recipients over a 9 year period were included. Clinical records were examined to detail any exposure to inotropic support prior to transplantation as well as presence or absence of peripheral blood eosinophilia. Pathology reports of explanted hearts as well as any pre-transplant endomyocardial biopsies were reviewed and the presence or absence of eosinophils on histology was documented. Results 28 patients (36.8%) of the group received dobutamine therapy prior to transplantation. Of these, 7 patients (25% of those receiving dobutamine, 9.2% of the total cohort) were found to have evidence of an eosinophilic infiltrate on myocardial histology (6 on explant, 1 on pre-transplant endomyocardia biopsy). All 7 patients had prolonged exposure to dobutamine prior to diagnosis of eosinophilic myocarditis. The duration of inotropic support ranged from 1 to 19 weeks; and the final maintenance dose of dobutamine ranged from 2.5 to 12.5 mcg/kg/min. One patient had a significant persistent peripheral blood eosinophilia for the duration of dobutamine therapy, 1.22 × 10 9 /L at peak (normal range 0.04 0.4 × 10 9 /L). A further 5 patients had short-lived ( 9 /L) in peripheral eosinophil count. Eosinophil count in these cases returned to normal without change in dobutamine dose or discontinuation. The patient with eosinophil infiltration on pre-transplant biopsy had dobutamine discontinued and histology of the explanted heart revealed complete resolution of the myocarditis. No eosinophilic infiltrates were identified in dobutamine-nave explants in the cohort, including 22 patients on prolonged therapy with intravenous milrinone. Conclusions One in four patients exposed to prolonged dobutamine therapy in this series developed eosinophilic myocarditis. Additionally, complete resolution of eosinophilic myocarditis after discontinuation of dobutamine was detailed in vivo in one case. The clinical impact of this process in a heart failure cohort is not clearly understood. Specific attention may need to be paid to peripheral blood eosinophil count in patients requiring prolonged inotropic support.

In the present study, we tried to clarify whether nuclear hypersegmentation of peripheral blood eosinophils is correlated with peripheral eosinophil counts and/or the activity of atopic dermatitis (AD) in 79 patients. We also compared the grades of skin scores, peripheral eosinophil counts, the rate of hypersegmentation of eosinophils and serum eosinophil cationic protein (ECP) concentrations in eight patients before and after treatment. There was a positive correlation between the skin scores of AD and peripheral eosinophil counts (P < 0.01), between the skin scores of AD and the number of nuclear lobes of eosinophils (P < 0.01) and between eosinophil counts and the number of nuclear lobes of eosinophils when the number of nuclear lobes of eosinophils was fewer than three (P < 0.01). A positive correlation was observed between serum ECP concentrations and eosinophil counts and/or skin scores of AD (P < 0.001). A negative correlation was observed between serum ECP concentrations and the number of nuclear lobes fewer than two (P < 0.05). During therapy, peripheral eosinophil counts and the degree of hypersegmented eosinophils decreased significantly, and this was associated with recovery of skin conditions, but not with serum ECP concentrations. These results suggest that eosinophil hypersegmentation may reflect activated eosinophils and also that the observation of nuclear hypersegmentation in peripheral blood eosinophils is useful to recognize the disease activity of AD.