What Is Eosinophilic Asthma?

Though we tend to think of asthma as a single disease, in recent years medical science has begun to distinguish between different types of asthma. One unusual but often severe type is known as eosinophilic asthma. It gets its name from eosinophils, which are white blood cells that cause inflammation, swelling, and airway obstructions when they crowd into the lungs and other respiratory organs. Eosinophilic asthma is most common in adults between the ages of 35 and 50, even those who have previously been asthma- and allergy-free. An estimated five percent of American adults may have eosinophilic asthma.

If you experience severe asthma symptoms, you may have eosinophilic asthma. Seek medical attention immediately. The emergency department at any Baptist Health medical facility is ready to help you. If your reaction is relatively mild, contact your Baptist Health physician for consultation and treatment.

What Are the Symptoms of Eosinophilic Asthma?

The symptoms of eosinophilic asthma include:

• Labored breathing
• Nasal congestion and runny nose
• Red, irritated eyes
• Tearing up
• Coughing and wheezing, sometimes worse at night
• Tightness in the chest

Individuals with eosinophilic asthma will have elevated levels of eosinophils in their bloodstream, lungs, and sputum (pulmonary mucous). Nasal polyps are also common in persons with this type of asthma.

Eosinophilic asthma is different from other forms of the disease in a number of ways: it first comes on in adulthood rather than childhood; it doesn’t appear to be linked to any allergies; it affects the entire respiratory system, not just the lungs; and it often doesn’t respond well to medications that are effective with other forms of asthma.

What Causes Eosinophilic Asthma?

Why eosinophils should target the lungs and other respiratory organs for an immune response is currently unknown. They are normally concentrated in other areas of the body, including parts of the brain and the lymphatic system.

Persons most at risk are those between the ages 35 and 50. Older and younger populations are sometimes vulnerable as well. Eosinophilic asthma appears equally prevalent in men and women.

How is Eosinophilic Asthma Diagnosed?

Eosinophilic asthma symptoms are often severe. If you’ve already been diagnosed with asthma but fail to respond to the standard treatments, your physician will likely investigate the possibility of your having the eosinophilic form of the disease. To determine this, your physician will measure the eosinophil levels in a sample of your blood, sputum, or saliva. He or she will draw a sample and send it to a medical lab for analysis. If your eosinophil levels are higher than normal, you may have eosinophilic asthma.

Because elevated eosinophil counts are also associated with other medical conditions, your physician will need to perform some additional tests, looking for corroborating evidence. One common sign of eosinophilic asthma is the presence of nasal polyps in the nose or sinuses. Your doctor will look for nasal polyps during a physical exam. A CT scan may be required in some cases.

How Is Eosinophilic Asthma Treated?

Asthma is controlled rather than cured. Treatment goals include symptom reduction, better breathing, an enhanced ability to handle the tasks and responsibilities of daily living, improved mood, and avoidance of emergency situations.

Standard asthma treatment focuses on long-term and quick-relief medications, especially inhaled and/or oral corticosteroids. These medications are not always effective with eosinophilic asthma. Medical researchers are finding that a relatively new category of drugs, called biologics, is superior in managing eosinophil-derived symptoms. Biologics originate in living organisms rather than in artificial laboratory processes. They work by attaching themselves to eosinophil cells, reducing their ability to generate an immune response. Biologics approved for treatment of eosinophilic asthma are:

• Benralizumab
• Dupilumab
• Mepolizumab
• Omalizumab
• Reslizumab

The fact that there are different types of asthma, differently caused and treated, is still a relatively recent discovery. New treatment methods, including the use of biologics, are a hopeful sign for anyone dealing with eosinophilic asthma.

Breathe Easier; Baptist Health Is Here to Help

If you suspect that you have eosinophilic asthma, see your Baptist Health primary care physician or allergy specialist. He or she can determine the true nature and extent of your condition, and make recommendations for dealing with it. If your symptoms are severe, call 911 or seek emergency medical care.