Eosinophilic asthma: rare, severe and treatable

Anyone with asthma knows how uncomfortable it is to occasionally cough, wheeze, and struggle for air. But for millions with this chronic condition, symptoms are well controlled with daily medications such as inhaled corticosteroids. When airway issues exacerbate, quick-acting medications come to the rescue.

But for people who developed asthma in adulthood, symptoms are often more frequent and dangerous—with standard-of-care inhaled corticosteroids ineffective in managing symptoms. This rare subtype of severe asthma is called eosinophilic asthma.

An eosinophil is a type of white blood cell that, as part of the immune system, protects the body from infection and disease. In eosinophilic asthma, these white blood cells build up in the airways, which include the nasal passages and sinuses, and symptoms develop that are more frequent and severe than in regular asthma.

How is eosinophilic asthma diagnosed?

Asthma, most commonly diagnosed in childhood, is a respiratory disease where the airways become inflamed, and mucus builds up. A physician makes a diagnosis by taking a detailed medical and family history and performs tests such as spirometry which measures how well the lungs are working.

However, an adult with severe symptoms may have developed eosinophilic asthma. In regular asthma, environmental factors such as pollen or pet hair can trigger an attack. In the eosinophilic form, it is an internal inflammatory process that triggers symptoms.

Your physician will conduct a variety of tests to arrive at an accurate diagnosis. They include an exhaled nitric oxide test to measure if nitrous oxide levels are normal, or are elevated, which is one indication of eosinophilic asthma.

A blood test or a sputum test measures if someone’s eosinophil levels show an elevation—another indicator of this form of the disease.

How is eosinophilic asthma treated?

Inhaled corticosteroids do an excellent job of relieving symptoms in regular asthma. In eosinophilic asthma, they are not as effective. Alternate therapy is to take oral steroids every day to control symptoms. However, this is not safe in the long run because of the way steroids affect every system in the body.

The good news is that medications called biologics are designed to improve lung function by reducing eosinophil production. These newer therapies are often given as an injection or administered via an intravenous infusion and quite literally, help people breathe easier, with a better quality of life, and breath.

A side note: Does eosinophilic asthma relate to rheumatoid arthritis?

Recently, researchers have begun to understand that people with asthma may have a greater chance of developing diseases such as rheumatoid arthritis*—a systemic disease where the immune system mistakenly kicks into overdrive, causing damaging inflammation in the joints and organs of the body. Much study is underway to explore this complex connection and how to apply the findings clinically.*