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Jesenak M, Diamant Z, Simon D, Tufvesson E, Seys SF, Mukherjee M, Lacy P, Vijverberg S, Slisz T, Sediva A, Simon HU, Striz I, Plevkova J, Schwarze J, Kosturiak R, Alexis NE, Untersmayr E, Vasakova MK, Knol E, Koenderman L. Eosinophils-from cradle to grave: An EAACI task force paper on new molecular insights and clinical functions of eosinophils and the clinical effects of targeted eosinophil depletion. Allergy 2023; 78:3077-3102. [PMID: 37702095 DOI: 10.1111/all.15884] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/14/2023]
Abstract
Over the past years, eosinophils have become a focus of scientific interest, especially in the context of their recently uncovered functions (e.g. antiviral, anti-inflammatory, regulatory). These versatile cells display both beneficial and detrimental activities under various physiological and pathological conditions. Eosinophils are involved in the pathogenesis of many diseases which can be classified into primary (clonal) and secondary (reactive) disorders and idiopathic (hyper)eosinophilic syndromes. Depending on the biological specimen, the eosinophil count in different body compartments may serve as a biomarker reflecting the underlying pathophysiology and/or activity of distinct diseases and as a therapy-driving (predictive) and monitoring tool. Personalized selection of an appropriate therapeutic strategy directly or indirectly targeting the increased number and/or activity of eosinophils should be based on the understanding of eosinophil homeostasis including their interactions with other immune and non-immune cells within different body compartments. Hence, restoring as well as maintaining homeostasis within an individual's eosinophil pool is a goal of both specific and non-specific eosinophil-targeting therapies. Despite the overall favourable safety profile of the currently available anti-eosinophil biologics, the effect of eosinophil depletion should be monitored from the perspective of possible unwanted consequences.
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Affiliation(s)
- Milos Jesenak
- Department of Clinical Immunology and Allergology, University Teaching Hospital in Martin, Martin, Slovak Republic
- Department of Paediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovak Republic
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovak Republic
| | - Zuzana Diamant
- Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden
- Department Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Dagmar Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ellen Tufvesson
- Department of Clinical Sciences Lund, Respiratory Medicine, Allergology and Palliative Medicine, Lund University, Lund, Sweden
| | - Sven F Seys
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Manali Mukherjee
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- The Firestone Institute for Respiratory Health, Research Institute of St. Joe's Hamilton, Hamilton, Ontario, Canada
| | - Paige Lacy
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Susanne Vijverberg
- Amsterdam UMC Location University of Amsterdam, Pulmonary Diseases, Amsterdam, The Netherlands
| | - Tomas Slisz
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Anna Sediva
- Department of Immunology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
| | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Institute of Biochemistry, Brandenburg Medical School, Neuruppin, Germany
| | - Ilja Striz
- Department of Clinical and Transplant Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jana Plevkova
- Department of Pathophysiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Jurgen Schwarze
- Child Life and Health and Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Radovan Kosturiak
- Department of Paediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovak Republic
- Outpatient Clinic for Clinical Immunology and Allergology, Nitra, Slovak Republic
| | - Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, Department of Paediatrics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Martina Koziar Vasakova
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Edward Knol
- Department Center of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Leo Koenderman
- Department Center of Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department Pulmonary Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
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Si J, Zhang X, Chen N, Sun F, Du P, Li Z, Tian D, Sun X, Sun G, Cong T, Du X, Liu Y. Case Report: Multimodal Imaging Guides the Management of an Eosinophilic Leukemia Patient With Eosinophilic Myocarditis and Intracardiac Thrombus. Front Cardiovasc Med 2022; 9:903323. [PMID: 35722086 PMCID: PMC9204136 DOI: 10.3389/fcvm.2022.903323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Background Eosinophilic leukemia (EL) is a rare, serious and potentially life-threatening condition characterized by the overproduction of eosinophils leading to tissue eosinophilic infiltration and damage. Although multiple organ systems may be involved, progressive eosinophilic myocarditis (EM) is the most common cause of morbidity and mortality. Early diagnosis and follow-up surveillance combined with multimodal imaging are crucial for appropriate treatment of EM. Case Summary It’s a rare case of EL with EM and intracardiac thrombus in a 59-year-old patient who presented with asthenia for 3 weeks. Full blood count analysis indicated significant eosinophilia. Bone marrow aspirate revealed dysplastic eosinophilia and a FIP1L1-PDGFRA fusion gene (4q12) was detected, confirming EL. Echocardiography revealed EM with intracardiac thrombus. This was later confirmed by cardiac magnetic resonance imaging. The patient was commenced on imatinib and prednisolone and good clinical response was obtained. Through 18F-FAPI PET/CT imaging, we obtained in vivo visualization of fibroblast activation changes in the early stage of cardiac structure remodeling. With anti-fibrotic therapy after heart failure, the patient achieved a good clinical response. Conclusion This case demonstrates in vivo visualization of fibroblast activation after EM. Multimodality imaging can provide early diagnosis and may guide tailored antifibrotic therapy in early stage of EM.
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Affiliation(s)
- Jinping Si
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xinxin Zhang
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Na Chen
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Fangfang Sun
- Department of Nuclear Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ping Du
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhiyong Li
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Di Tian
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiuli Sun
- Department of Hematology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Guozhen Sun
- Department of Hematology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tao Cong
- Department of Ultrasonography, First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Tao Cong,
| | - Xuemei Du
- Department of Nuclear Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Xuemei Du,
| | - Ying Liu
- Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
- Ying Liu,
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Aukstuolis K, Cooper JJ, Altman K, Lang A, Ayars AG. Hypereosinophilic syndrome presenting as coagulopathy. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2022; 18:25. [PMID: 35317854 PMCID: PMC8941788 DOI: 10.1186/s13223-022-00666-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
Abstract
Background Hypereosinophilic syndrome (HES) is an extremely uncommon group of disorders. It rarely presents with coagulopathy without cardiac involvement. Case presentation A 33-year-old previously healthy male with no history of atopic disease presented with abdominal pain, hematochezia, peripheral eosinophilia as high as 10,000 eos/µL, right and left portal vein, mesenteric, and splenic vein thrombi with ischemic colitis resulting in hemicolectomy and small bowel resection. Despite an extensive workup for primary and secondary etiologies of hypereosinophilia by hematology/oncology, infectious disease, rheumatology and allergy/immunology, no other clear causes were identified, and the patient was diagnosed with idiopathic HES. His eosinophilia was successfully treated with high-dose oral corticosteroids (OCS) and subsequently transitioned to anti-IL-5-receptor therapy with benralizumab. He has continued this treatment for over a year with no recurrence of eosinophilia or thrombosis while on benralizumab. Conclusion In patients with an unexplained coagulopathy and eosinophilia, eosinophilic disorders such as HES should be considered. Corticosteroid-sparing agents, such as benralizumab show promise for successfully treating these patients.
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Affiliation(s)
- Kestutis Aukstuolis
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA. .,Northwest Asthma and Allergy Center, Redmond, WA, 98052, USA.
| | - Jocelyn J Cooper
- Division of Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Katherine Altman
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Anna Lang
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Andrew G Ayars
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
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Nagamura N, Fukiwake N, Ozasa R. Steroid Resistant Hypereosinophilic Syndrome Suspected to Be Caused by Aberrant T-cell Subset. Kurume Med J 2020; 65:185-191. [PMID: 31723076 DOI: 10.2739/kurumemedj.ms654003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 53-year-old male presented with cough, skin rash and lymphadenopathies complicated with hypereosinophilia (HE) in the blood, and patchy shadows in both lungs on chest computed tomography. Reactive causes for HE were excluded, and no clinical or laboratory features of myeloproliferative disorders could be found. HE caused by aberrant T-cell subsets was suspected because of serum hyper-immunoglobulin E level, and organ involvement of skin and lungs, though we could show neither aberrant T-cell surface markers nor T-cell receptor gene rearrangement. In the course of steroid monotherapy, tolerable maintenance dose could not be attained and the steroid-sparing agents of hydroxycarbamide, cyclosporine and interferon-α were introduced. However, the therapeutic response was inadequate, and organ involvement of lungs and intestinal tract developed. HE caused by aberrant T-cell subsets has steroid resistance and a risk of malignant transition, and we considered this progressive steroid refractoriness to be a sign of such a transition. Cytotoxic chemotherapy or bone marrow transplantation will likely be the next treatment modality in this patient.
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Affiliation(s)
- Norihiro Nagamura
- Department of Rheumatology and Allergy, Shimane Prefectural Central Hospital
| | - Noriko Fukiwake
- Department of General Medicine, Shimane Prefectural Central Hospital
| | - Ryotaro Ozasa
- Department of General Medicine, Shimane Prefectural Central Hospital
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5
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Hypereosinophiles Syndrom und weitere rheumatische Erkrankungen mit Hypereosinophilie. Z Rheumatol 2019; 78:322-332. [DOI: 10.1007/s00393-019-0623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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[Chinese expert consensus on the diagnosis and treatment of eosinophilia (2017)]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2017; 38:561-565. [PMID: 28810320 PMCID: PMC7342274 DOI: 10.3760/cma.j.issn.0253-2727.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Indexed: 12/27/2022]
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7
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Butt NM, Lambert J, Ali S, Beer PA, Cross NCP, Duncombe A, Ewing J, Harrison CN, Knapper S, McLornan D, Mead AJ, Radia D, Bain BJ. Guideline for the investigation and management of eosinophilia. Br J Haematol 2017; 176:553-572. [PMID: 28112388 DOI: 10.1111/bjh.14488] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Nauman M Butt
- Royal Liverpool and Broadgreen University Teaching Hospitals NHS Trust, Liverpool, UK
| | - Jonathan Lambert
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Sahra Ali
- Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
| | | | | | - Andrew Duncombe
- Department of Haematology, University Hospital Southampton, Southampton, UK
| | - Joanne Ewing
- Heart of England NHS Foundation Trust, Birmingham, UK
| | | | - Steven Knapper
- Division of Cancer & Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Donal McLornan
- King's College Hospital NHS Foundation Trust, London, UK
| | - Adam J Mead
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford and BRC Blood Theme, NIHR Oxford Biomedical Centre, Oxford, UK
| | - Deepti Radia
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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8
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Madden VR, Schoeffler GL. Idiopathic hypereosinophilic syndrome resulting in distal aortic thromboembolism in a dog. J Vet Emerg Crit Care (San Antonio) 2016; 26:819-824. [DOI: 10.1111/vec.12545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/04/2014] [Accepted: 01/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Valerie R. Madden
- Department of Clinical Sciences; Cornell University College of Veterinary Medicine; Ithaca NY 14853
| | - Gretchen L. Schoeffler
- Department of Clinical Sciences; Cornell University College of Veterinary Medicine; Ithaca NY 14853
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9
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Gao SJ, Wei W, Chen JT, Tan YH, Yu CB, Litzow MR, Liu QJ. Hypereosinophilic syndrome presenting with multiple organ infiltration and deep venous thrombosis: A case report and literature review. Medicine (Baltimore) 2016; 95:e4658. [PMID: 27583887 PMCID: PMC5008571 DOI: 10.1097/md.0000000000004658] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Hypereosinophilic syndrome (HES) can be fatal, particularly when eosinophils infiltrate vital organs and/or if extensive thrombosis develops. However there are no standard recommendations for the use of anticoagulant therapy of HES in the setting of thrombosis. METHODS We herein present a case of a 46-year-old female who presented with marked peripheral eosinophilia with symptoms of multi-organ infiltration and extensive deep venous thrombosis (DVT). In this case, evaluation was carried out before the diagnosis was established, and timely standard-dose corticosteroids combined with a new oral anticoagulant (NOAC) therapy were carried out. RESULTS These measures resulted in a rapid response and long-term disease control. CONCLUSION Although there are no data to support which anticoagulant is preferred in this setting, this case indicates that the new oral anticoagulants may play an important role in the treatment of thrombosis in HES.
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Affiliation(s)
- Su-jun Gao
- Hematology section, Cancer Center, the First Hospital of Jilin University
| | - Wei Wei
- Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Jiang-tao Chen
- Hematology section, Cancer Center, the First Hospital of Jilin University
| | - Ye-hui Tan
- Hematology section, Cancer Center, the First Hospital of Jilin University
| | - Cheng-bao Yu
- Second Department of Cardiology, The First Hospital of Qiqihaer Hospital, Qiqihaer, Heilongjiang, China
| | | | - Qiu-ju Liu
- Hematology section, Cancer Center, the First Hospital of Jilin University
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
- Correspondence: Qiu-ju Liu, Hematology Section, Cancer Center, The First Hospital of Jilin University, No 71 Xinmin Street, Changchun 130021, China (e-mail: )
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10
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Abstract
The symptomatic hypereosinophilic patient must be approached in a stepwise manner, with thorough assessment to determine whether the hypereosinophilia itself is contributing to damage and disease manifestations (thereby defining a hypereosinophilic syndrome), and to identify an eventual cause of hypereosinophilia, followed by initiation of treatment directed against the underlying condition or deleterious hypereosinophilic state. Situations encountered in the clinic are extremely heterogeneous because of the numerous potential causes of hypereosinophilia and the variable spectrum of eosinophil-mediated organ damage. A practical approach to many of these situations is presented in this review.
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11
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Eosinophile Granulozyten. ALLERGOLOGIE 2016. [DOI: 10.1007/978-3-642-37203-2_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Weyand AC, Yanik GA, Bailey NG, Wu YM, Mody RJ, Castle VP. Imatinib Treatment in PDGFRA-Negative Childhood Hypereosinophilic Syndrome. Pediatr Blood Cancer 2016; 63:164-7. [PMID: 26257279 DOI: 10.1002/pbc.25702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/20/2015] [Indexed: 01/29/2023]
Abstract
We report a 4-year-old female who presented with severe hypereosinophilia (215.7 K/μl) and end-organ dysfunction. Extensive evaluation including whole exome sequencing was performed, revealing no causative mutation. Initial treatment with corticosteroids, leukapheresis, and hydroxyurea decreased her absolute eosinophil count (AEC), although it remained elevated. Despite the absence of a PDGFRA mutation, an imatinib trial resulted in normalization of her AEC. Imatinib was discontinued after sustained normal counts for 1 month. AECs have remained normal for more than 1 year off therapy. This provides support for consideration of imatinib in the treatment of hypereosinophilia even in the absence of a known tyrosine kinase mutation.
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Affiliation(s)
- Angela C Weyand
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical Center, Ann Arbor, Michigan
| | - Gregory A Yanik
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical Center, Ann Arbor, Michigan
| | - Nathanael G Bailey
- Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
| | - Yi-Mi Wu
- Michigan Center of Translational Pathology (MCTP), University of Michigan Medical Center, Ann Arbor, Michigan
| | - Rajen J Mody
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical Center, Ann Arbor, Michigan
| | - Valerie P Castle
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Communicable Diseases, University of Michigan Medical Center, Ann Arbor, Michigan
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Ogbogu PU, Klion AD. Hypereosinophilic disorders. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2015; 3:304-5; quiz 306. [PMID: 25754721 DOI: 10.1016/j.jaip.2014.09.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 09/05/2014] [Indexed: 10/23/2022]
Affiliation(s)
- Princess U Ogbogu
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Amy D Klion
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
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14
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Nemchenko IS, Turkina AG, Chelysheva EY, Galstyan GM, Kovrigina AM, Khuazheva NK, Savchenko VG. [FIP1L1-PDGFRА-positive myeloproliferative disease with eosinophilia: A rare case with multiple organ dysfunction and a response to tyrosine kinase inhibitor therapy]. TERAPEVT ARKH 2015; 87:89-95. [PMID: 26978425 DOI: 10.17116/terarkh2015871289-95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The described case of FIP1L1-PDGFRА-positive myeloproliferative disease is characterized by an atypical aggressive course to develop severe specific complications as injuries to the brain, heart, lung, and intestine. Pathogenetic therapy with imatinib could stabilize a patient's state, but failed to produce a complete hematological response. Switching from imatinib to dasatinib could produce sustained clinical, hematological, and molecular remissions.
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Affiliation(s)
- I S Nemchenko
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - A G Turkina
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - E Yu Chelysheva
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - G M Galstyan
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - A M Kovrigina
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
| | - N K Khuazheva
- S.P. Botkin City Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
| | - V G Savchenko
- Hematology Research Center, Ministry of Health of Russia, Moscow, Russia
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15
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Radonjic-Hoesli S, Valent P, Klion AD, Wechsler ME, Simon HU. Novel targeted therapies for eosinophil-associated diseases and allergy. Annu Rev Pharmacol Toxicol 2014; 55:633-56. [PMID: 25340931 DOI: 10.1146/annurev-pharmtox-010814-124407] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Eosinophil-associated diseases often present with life-threatening manifestations and/or chronic organ damage. Currently available therapeutic options are limited to a few drugs that often have to be prescribed on a lifelong basis to keep eosinophil counts under control. In the past 10 years, treatment options and outcomes in patients with clonal eosinophilic and other eosinophilic disorders have improved substantially. Several new targeted therapies have emerged, addressing different aspects of eosinophil expansion and inflammation. In this review, we discuss available and currently tested agents as well as new strategies and drug targets relevant to both primary and secondary eosinophilic diseases, including allergic disorders.
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16
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Park JH, Kim BH, Kim MK, Lee JE, Kim KT, Yoo JJ, Kim HJ, Jung SW, Kim CH, Hyun IG, Choi JH. Eosinophilic cholecystitis: A rare manifestation of hypereosinophilic syndrome. ALLERGY ASTHMA & RESPIRATORY DISEASE 2014. [DOI: 10.4168/aard.2014.2.3.222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jae-Hyun Park
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Byoung-Hoon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Mi-Kang Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jae-Eun Lee
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Kwang-Taek Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jun-Jae Yoo
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hee-Jun Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Sung-Won Jung
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Cheol-Hong Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea
| | - In-Gyu Hyun
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea
| | - Jeong-Hee Choi
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
- Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea
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17
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Johnson RC, George TI. The Differential Diagnosis of Eosinophilia in Neoplastic Hematopathology. Surg Pathol Clin 2013; 6:767-794. [PMID: 26839197 DOI: 10.1016/j.path.2013.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Eosinophilia in the peripheral blood is classified as primary (clonal) hematologic neoplasms or secondary (nonclonal) disorders, associated with hematologic or nonhematologic disorders. This review focuses on the categories of hematolymphoid neoplasms recognized by the 2008 World Health Organization Classification of Tumours and Haematopoietic and Lymphoid Tissues that are characteristically associated with eosinophilia. We provide a systematic approach to the diagnosis of these neoplastic proliferations via morphologic, immunophenotypic, and molecular-based methodologies, and provide the clinical settings in which these hematolymphoid neoplasms occur. We discuss recommendations that eosinophilia working groups have published addressing some of the limitations of the current classification scheme.
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Affiliation(s)
- Ryan C Johnson
- Department of Pathology, Stanford University School of Medicine, 300 Pasteur Drive, L235 MC 5324, Stanford, CA 94305, USA.
| | - Tracy I George
- Department of Pathology, University of New Mexico School of Medicine, 1 University of New Mexico, MSC08 4640, Albuquerque, NM 87131-0001, USA
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18
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Havelange V, Demoulin JB. Review of current classification, molecular alterations, and tyrosine kinase inhibitor therapies in myeloproliferative disorders with hypereosinophilia. J Blood Med 2013; 4:111-21. [PMID: 23976869 PMCID: PMC3747024 DOI: 10.2147/jbm.s33142] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Recent advances in our understanding of the molecular mechanisms underlying hypereosinophilia have led to the development of a ‘molecular’ classification of myeloproliferative disorders with eosinophilia. The revised 2008 World Health Organization classification of myeloid neoplasms included a new category called “myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1.” Despite the molecular heterogeneity of PDGFR (platelet-derived growth factor receptor) rearrangements, tyrosine kinase inhibitors at low dose induce rapid and complete hematological remission in the majority of these patients. Other kinase inhibitors are promising. Further discoveries of new molecular alterations will direct the development of new specific inhibitors. In this review, an update of the classifications of myeloproliferative disorders associated with hypereosinophilia is discussed together with open and controversial questions. Molecular mechanisms and promising results of tyrosine kinase inhibitor treatments are reviewed.
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Affiliation(s)
- Violaine Havelange
- de Duve Institute, Université catholique de Louvain, Brussels, Belgium ; Department of Hematology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
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Simon D, Simon HU, Yousefi S. Extracellular DNA traps in allergic, infectious, and autoimmune diseases. Allergy 2013; 68:409-16. [PMID: 23409745 DOI: 10.1111/all.12111] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2012] [Indexed: 12/16/2022]
Abstract
Extracellular DNA traps are part of the innate immune response and are seen with many infectious, allergic, and autoimmune diseases. They can be generated by several different leukocytes, including neutrophils, eosinophils, and monocytes, as well as mast cells. Here, we review the composition of these extracellular DNA-containing structures as well as potential mechanisms for their production and function. In general, extracellular DNA traps have been described as binding to and killing pathogens, particularly bacteria, fungi, but also parasites. On the other hand, it is possible that DNA traps contribute to immunopathology in chronic inflammatory diseases, such as bronchial asthma. In addition, it has been demonstrated that they can initiate and/or potentiate autoimmune diseases. Extracellular DNA traps represent a frequently observed phenomenon in inflammatory diseases, and they appear to participate in the cross-talk between different immune cells. These new insights into the pathogenesis of inflammatory diseases may open new avenues for targeted therapies.
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Affiliation(s)
- D. Simon
- Department of Dermatology; Inselspital; Bern University Hospital; Bern; Switzerland
| | - H.-U. Simon
- Institute of Pharmacology; University of Bern; Bern; Switzerland
| | - S. Yousefi
- Institute of Pharmacology; University of Bern; Bern; Switzerland
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Eosinophil extracellular DNA traps: molecular mechanisms and potential roles in disease. Curr Opin Immunol 2012; 24:736-9. [DOI: 10.1016/j.coi.2012.08.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 08/22/2012] [Indexed: 01/01/2023]
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