Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain.
Department of Allergology, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain.
Front Immunol. 2023 May 17;14:1192284. doi: 10.3389/fimmu.2023.1192284. eCollection 2023.
Elevated eosinophil counts in blood and tissue are a feature of many pathological processes. Eosinophils can migrate and accumulate in a wide variety of tissues and, by infiltrating a target organ, can mediate the development of several inflammatory diseases. The normalization of eosinophilia is a common biomarker of a treatable trait and can also be used as a prognostic and predictive biomarker since it implies a reduction in type 2 inflammation that contributes to disease pathogenesis. Biological therapies targeting this cell type and its proinflammatory mediators have been shown to be effective in the management of a number of eosinophilic diseases, and for this reason they constitute a potential common strategy in the treatment of patients with various multimorbidities that present with type 2 inflammation. Various biological options are available that could be used to simultaneously treat multiple target organs with a single drug, bearing in mind the need to offer personalized treatments under the umbrella of precision medicine in all patients with eosinophil-associated diseases (EADs). In addition to reviewing these issues, we also discuss a series of perspectives addressing the management of EAD patients from a multidisciplinary approach, with the collaboration of health professionals from different specialties who manage the different multimorbidities that frequently occur in these patients. We examine the basic principles of care that this multidisciplinary approach must cover and present a multidisciplinary expert opinion regarding the ideal management of patients with EADs, from diagnosis to therapeutic approach and follow-up.
血液和组织中嗜酸性粒细胞计数升高是许多病理过程的特征。嗜酸性粒细胞可以迁移并积聚在多种组织中,并通过浸润靶器官,介导几种炎症性疾病的发展。嗜酸性粒细胞增多症的正常化是一种可治疗特征的常见生物标志物,也可用作预后和预测生物标志物,因为它意味着 2 型炎症的减少,这有助于疾病的发病机制。针对这种细胞类型及其促炎介质的生物疗法已被证明在许多嗜酸性疾病的治疗中有效,因此,它们构成了治疗具有 2 型炎症的各种多种合并症患者的潜在共同策略。有各种生物选择可供使用,可以用一种药物同时治疗多个靶器官,同时考虑到在所有患有嗜酸性粒细胞相关疾病(EAD)的患者中,需要在精准医学的框架下提供个性化治疗。除了回顾这些问题外,我们还从多学科方法讨论了一系列关于 EAD 患者管理的观点,该方法涉及来自不同专业的卫生专业人员,他们管理这些患者中经常出现的不同多种合并症。我们研究了这种多学科方法必须涵盖的护理基本原则,并就 EAD 患者的理想管理提出了多学科专家意见,从诊断到治疗方法和随访。