Khoury Paneez, Grayson Peter C, Klion Amy D
Laboratory of Parasitic Diseases, National Institutes of Allergic and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
Vasculitis Translational Research Program, National Institutes of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD 20892, USA.
Nat Rev Rheumatol. 2014 Aug;10(8):474-83. doi: 10.1038/nrrheum.2014.98. Epub 2014 Jul 8.
Eosinophils are multifunctional granular leukocytes that are implicated in the pathogenesis of a wide variety of disorders, including asthma, helminth infection, and rare hypereosinophilic syndromes. Although peripheral and tissue eosinophilia can be a feature of many types of small-vessel and medium-vessel vasculitis, the role of eosinophils has been best studied in eosinophilic granulomatosis with polyangiitis (EGPA), where eosinophils are a characteristic finding in all three clinical stages of the disorder. Whereas numerous studies have demonstrated an association between the presence of eosinophils and markers of eosinophil activation in the blood and tissues of patients with EGPA, the precise role of eosinophils in disease pathogenesis has been difficult to ascertain owing to the complexity of the disease process. In this regard, results of clinical trials using novel agents that specifically target eosinophils are providing the first direct evidence of a central role of eosinophils in EGPA. This Review focuses on the aspects of eosinophil biology most relevant to the pathogenesis of vasculitis and provides an update of current knowledge regarding the role of eosinophils in EGPA and other vasculitides.
嗜酸性粒细胞是多功能的粒细胞，与多种疾病的发病机制有关，包括哮喘、蠕虫感染和罕见的嗜酸性粒细胞增多综合征。虽然外周血和组织嗜酸性粒细胞增多可能是多种类型小血管和中血管血管炎的一个特征，但嗜酸性粒细胞的作用在嗜酸性肉芽肿性多血管炎（EGPA）中研究得最为充分，在该疾病的所有三个临床阶段，嗜酸性粒细胞都是一个特征性表现。尽管大量研究表明，EGPA患者的血液和组织中嗜酸性粒细胞的存在与嗜酸性粒细胞活化标志物之间存在关联，但由于疾病过程的复杂性，嗜酸性粒细胞在疾病发病机制中的精确作用一直难以确定。在这方面，使用特异性靶向嗜酸性粒细胞的新型药物的临床试验结果首次直接证明了嗜酸性粒细胞在EGPA中起核心作用。本综述重点关注与血管炎发病机制最相关的嗜酸性粒细胞生物学方面，并提供有关嗜酸性粒细胞在EGPA和其他血管炎中作用的当前知识更新。
