BACKGROUND Hepatic eosinophilic pseudotumor(HEPT)is a rare condition that mimics ma-lignant hepatic tumors,posing significant diagnostic challenges.This case report highlights the importance of considering parasitic i...BACKGROUND Hepatic eosinophilic pseudotumor(HEPT)is a rare condition that mimics ma-lignant hepatic tumors,posing significant diagnostic challenges.This case report highlights the importance of considering parasitic infections like Fasciola hepatica(F.hepatica)in the differential diagnosis of hepatic masses,especially in endemic regions,to prevent unnecessary interventions.CASE SUMMARY A 40-year-old female presented with a 1-month history of epigastric pain and significant weight loss.Imaging revealed a hepatic mass,initially misdiagnosed as intrahepatic cholangiocarcinoma.Laboratory results showed marked eosinophilia,and histopathological examination confirmed significant eosinophilic infiltration without malignancy.Serological testing identified F.hepatica infection.The patient was treated with a single dose of triclabendazole,leading to complete symptom resolution and normalization of hepatic imaging findings within days.CONCLUSION HEPT due to F.hepatica can closely mimic malignancy;timely antiparasitic treat-ment is crucial for resolution.展开更多
BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patient...BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain(CAP).METHODS A retrospective analysis was conducted on case records of children with CAP.Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation.Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID.Subsequent analyses included clinical presentations,presence of atopy in the children or family,hemoglobin,albumin,serum immunoglobulin E(IgE),fecal calprotectin levels,endoscopic appearances,treatment methods,and outcomes.RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation.Among them,19(5.2%)patients with CAP were diagnosed with EGID.The median age of the children was 11.1 years(interquartile range=8.4-14.4).The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years.Periumbilical pain was the most common site(63%).Family history of atopy,peripheral blood eosinophilia,and elevated serum IgE were the three parameters significantly associated with EGID.Clinical remission was obtained in all children at 6 months.The 47%had microscopic remission and maintained remission until a 1-year follow-up.The 53%had a fluctuating clinical course after 6 months.CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India.It can contribute significantly to the etiology of pediatric CAP.展开更多
Background:Allergic eosinophilic asthma(EA)and eosinophilic granulomatosis with polyangiitis(EGPA)share significant overlaps in both epidemiology and pathogenesis,suggesting a potential link between the two con-dition...Background:Allergic eosinophilic asthma(EA)and eosinophilic granulomatosis with polyangiitis(EGPA)share significant overlaps in both epidemiology and pathogenesis,suggesting a potential link between the two con-ditions.Despite these associations,the underlying molecular and cellular mechanisms driving their connection remain poorly understood.Methods:We retrieved GSE143303 of EA and GSE144302 of EGPA from the GEO database and conducted dif-ferential expression analysis as well as functional enrichment analysis to identify differentially expressed genes(DEGs)and potential pathogenic pathways.A protein-protein interaction(PPI)network was generated using the STRING database.Key hub genes were determined through cytoHubba.We added two publicly reported EA and EGPA-related transcriptome datasets,GSE117038 and GSE119136,for mutual verification.Subsequent valida-tion was performed via immune infiltration assessment utilizing CIBERSORT.Results:In total,267 DEGs were identified,in which HSP90AA1,HSPA8,CCND1,RPS20,CD74,RPL5,RPS6,RHOA,RPS3A and FLT3LG are the top 10 hub genes,while the antigen processing and presentation pathway and leukocyte cell-cell adhesion pathway were the potential influential pathways.Increased naïve B cells and M1 type of Macrophages were detected in EA patients through immune infiltration analysis.Conclusions:Utilizing bioinformatics techniques,this study is the initial investigation to uncover the shared mechanisms involving the antigen processing and presentation pathway and leukocyte adhesion pathways in the progression of both EA and EGPA.It may offer potential biomarkers for future studies on the underlying path-ogenesis and treatment of EA and EGPA as well as eosinophilia related co-morbidities.展开更多
Background:Hypereosinophilia(HE)is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor.This case report presents the course and prognosis of a patient wi...Background:Hypereosinophilia(HE)is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor.This case report presents the course and prognosis of a patient with hypereosinophilia treated with suplatast tosilate monotherapy.Case presentation:A 41-year-old female patient who complained of“Elevated blood eosinophils were found during physical examination for more than 2 months”visited the Allergy Department.The systematic screening results of parasites,autoantibodies spectrum,tumor markers,peripheral blood morphology analysis,and leukemia fusion gene(FIP1L1-PDGFRα)were all negative.Gastrointestinal endoscopy only indicated mild gastritis.The dust mites and multiple fungal mixtures were weakly positive in intradermal tests.Finally diagnosed HE.After treatment with suplatast tosilate 2 months of 100mg three times daily,the blood eosinophils decreased to normal.Then,maintenance treatment with 50mg three times a day for 3 months.And without recurrence during nearly five years of follow-up.Conclusion:The report indicates that suplatast tosilate can reduce peripheral blood eosinophils levels in patients with HE,and may be a reliable option for individualized treatment of HE.However,there is still no consensus on whether suplatast tosilate can be used as a first-line treatment or as an adjuvant therapy to reduce the corticosteroids dosage for patients with eosinophilia,and further research is needed.展开更多
Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and femal...Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and females equally,though males may exhibit more active disease at diagnosis and often require more aggressive treatment(Liu et al.,2023).The hallmark features of EGPA include delayed-onset asthma,eosinophilia in tissues and blood,and vasculitis affecting small to medium-sized arteries(White and Dubey,2023).EGPA falls under the category of antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),whereas only about half of EGPA patients test positive for ANCA(Khoury et al.,2023).展开更多
Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of...Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of inflammatory responses.The most prevalent chronic inflammatory illness,rheumatoid arthritis(RA),is typified by persistent synovitis thatmakes it hard for the disease to go away on its own.Interestingly,a unique subset of eosinophils known as regulatory eosinophils has been found in RA patients’synovium,especially while the disease is in remission.Pro-resolving signatures of regulatory eosinophils in the synovium are distinct from those of their lung counterparts.The most recent research on eosinophils and their function in this disease pathogenesis is compiled in this review.Based on the role of regulatory eosinophils,a new pathological model of inflammation resolution in RA is proposed,and potential therapeutic strategies aimed at enhancing the action of regulatory eosinophils in RA are proposed.展开更多
Eosinophilic myocarditis(EM)is a rare inflammatory condition of the heart,often associated with eosinophilic infiltration.While its causes range from allergies to autoimmune and infectious diseases,parasitic infection...Eosinophilic myocarditis(EM)is a rare inflammatory condition of the heart,often associated with eosinophilic infiltration.While its causes range from allergies to autoimmune and infectious diseases,parasitic infections are an uncommon but critical etiology.This mini-review focuses on a case of EM in a 47-year-old male from Vietnam,linked to Schistosoma spp.,Strongyloides stercoralis,and Toxocara spp.infections.The patient presented with severe chest pain and recovered fully after treatment with corticosteroids and albendazole.Drawing insights from this case and existing literature,we discuss the pathophysiology,diagnostic approaches,and therapeutic strategies for parasite-induced EM.Early diagnosis and tailored treatment are essential to improve clinical outcomes,especially in endemic para-sitic areas.展开更多
BACKGROUND Eosinophilic esophagitis(EoE)is a chronic inflammatory disorder presenting as symptoms of dysphagia,esophageal food impaction,chest pain,and heartburn.After an initial trial of proton pump inhibitor(PPI)the...BACKGROUND Eosinophilic esophagitis(EoE)is a chronic inflammatory disorder presenting as symptoms of dysphagia,esophageal food impaction,chest pain,and heartburn.After an initial trial of proton pump inhibitor(PPI)therapy,swallowed topical corticosteroids(STC)are effective as induction therapy for EoE.However,out-come data for STC as a maintenance strategy is limited.RESULTS Three randomized control trials and one observational study were included,involving 303 patients(189 in the STC group,114 in the placebo-controlled group).Analysis showed that histologic recurrence was significantly lower with STC(OR:0.04,95%CI:0.01-0.28,P<0.00001,I^(2)=78%).Overall symptom recurrence was similar between groups(OR:0.23,95%CI:0.02-3.54,P=0.29,I^(2)=92%).On sensitivity analysis,symptom recurrence was significantly lower in the STC group(OR:0.05,95%CI:0.02-0.17,P=0.00001,I^(2)=39%).Odds of repeat dilation were significantly lower in the STC group(OR:0.14,95%CI:0.02-0.91,P=0.04,I^(2)=0%).Candida infection rates were similar between groups(OR:6.13,95%CI:0.85-44.26,P=0.07,I^(2)=24%).Proportion of concomitant PPI use was similar between groups(OR:1.64,95%CI:0.83-3.21,P=0.15,I^(2)=0%).CONCLUSION For patients who successfully achieved remission of EoE with STC induction therapy,maintaining treatment is effective in sustaining histologic remission,while newer regimens may be effective in preventing symptom recurrence compared to placebo.We found no significant difference for oropharyngeal/esophageal candidiasis with STC maintenance therapy.Future studies with longer follow-up periods are needed.展开更多
Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predi...Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predict NDMM patient outcomes. The Durie-Salmon (D-S) staging system reflects tumor burden and clinical progression staging with prognostic value.展开更多
Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophi...Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.展开更多
Introduction:Eosinophilia is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor that can reduce eosinophils.There is currently a lack of clinical studie...Introduction:Eosinophilia is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor that can reduce eosinophils.There is currently a lack of clinical studies of suplatast tosilate in the treatment of eosinophilia.Research objective:To explore whether suplatast tosilate can reduce blood eosinophil levels in eosinophilia and the factors that might influence the improvement.Methods:A real-world retrospective study of 20 patients with eosinophilia was conducted using electronic medical record information.The main outcome measure was the difference in peripheral blood absolute eosinophil count(AEC)and percentage(EOS%)before suplatast tosilate(baseline)and the lowest AEC during the 1-year period of suplatast tosilate treatment(post-treatment).Data on age,gender,disease duration,involved organs,and concomitant medication were collected,and subgroup analysis and linear regression analysis were performed.Results:Subjects were predominantly male,with a mean age of 33 years and a disease duration of approximately 30 months.After treatment with suplatast tosilate,the patient's AEC(p=0.029)and EOS%(p=0.016)significantly decreased.The decline in eosinophils was more pronounced in patients who were male,age<33 years,disease duration<30 months and gastrointestinal system involvement.In addition,the shorter the course of the disease,the greater the relative decrease in eosinophils after suplatast tosilate treatment(β=-0.018,p<0.001).Conclusions:Suplatast tosilate is effective in reducing peripheral blood eosinophil levels in patients with eosinophilia.Large-scale prospective cohort studies are needed for further confirmation.展开更多
BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease ...BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.展开更多
Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eos...Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eosinophilia. Diffuse gastrointestinal tract and colonic involvement are uncommon. The endoscopic appearance may vary from normal to mucosal nodularity and ulceration. Gastrointestinal obstruction is unusual and is associated with predominantly muscular disease. We present five unusual cases of EG associated with gastric outlet and duodenal obstruction. Two cases presented with acute pancreatitis and one had a history of pancreatitis. Four cases responded well to medical therapy and one had recurrent gastric outlet obstruction that required surgery. Four out of the five cases had endoscopic and histological evidence of esophagitis and two had colitis. Two patients had ascites. These cases reaffirm that EG is a disorder with protean manifestations and may involve the entire gastrointestinal tract. Gastric outlet and/or small bowel obstruction is an important though uncommon presentation of EG. It may also present as esophagitis, gastritis with polypoid lesions, ulcers or erosions, colitis and pancreatitis and may mimic malignancy.展开更多
Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 16...Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level.展开更多
Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endosc...Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion,including parasitic infections and drug-induced causes. Occasionally,the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized,in large part,due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea,in particular,endoscopic imaging and mucosal biopsies. Def inition of EGE,however,may be diffi cult,as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also,the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms,and,in some instances,eosinophil quantification in pre-treatment and post-treatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in defi nition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.展开更多
Eosinophilic oesophagitis(EoE)is an allergen/immune-mediated chronic esophageal disease characterized by esophageal mucosal eosinophilic infiltration and esophageal dysfunction.Although the disease was originally attr...Eosinophilic oesophagitis(EoE)is an allergen/immune-mediated chronic esophageal disease characterized by esophageal mucosal eosinophilic infiltration and esophageal dysfunction.Although the disease was originally attributed to a delayed allergic reaction to allergens and a Th2-type immune response,the exact pathogenesis is complex,and the efficacy of existing treatments is unsatisfactory.Therefore,the study of the pathophysiological process of EOE has received increasing attention.Animal models have been used extensively to study the molecular mechanism of EOE pathogenesis and also provide a preclinical platform for human clinical intervention studies of novel therapeutic agents.To maximize the use of existing animal models of EOE,it is important to understand the advantages or limitations of each modeling approach.This paper systematically describes the selection of experimental animals,types of allergens,and methods of sensitization and excitation during the preparation of animal models of EoE.It also discusses the utility and shortcomings of each model with the aim of providing the latest perspectives on EoE models and leading to better choices of animal models.展开更多
BACKGROUND Eosinophilic solid and cystic(ESC)renal cell carcinoma(RCC),a unique and emerging subtype of RCC,has an indolent nature;in some rare instances,it may exhibit metastatic potential.Current cases are inadequat...BACKGROUND Eosinophilic solid and cystic(ESC)renal cell carcinoma(RCC),a unique and emerging subtype of RCC,has an indolent nature;in some rare instances,it may exhibit metastatic potential.Current cases are inadequate to precisely predict the clinical outcome of ESC RCC and determine treatment choices.CASE SUMMARY Herein,we report two patients with ESC RCC.Patient 1 was a young woman with classical pathological characteristics.Patient 2 was a 52-year-old man with multifocal metastases,involving the pulmonary hilar and mediastinal lymph nodes,liver,brain,mesosternum,vertebra,rib,femur,and symphysis pubis.Awareness of ESC RCC,along with its characteristic architecture and immunophenotype,would contribute to making a definitive diagnosis,even on core biopsy samples.CONCLUSION The discovery of ESC RCC molecular signatures may provide new therapeutic strategies in the future.展开更多
In this work, lateral deformation of human eosinophil cell during the lateral indentation by an optically trapped microbead of diameter 4.5 µm is studied. The images were captured using a CCD camera and the Boltz...In this work, lateral deformation of human eosinophil cell during the lateral indentation by an optically trapped microbead of diameter 4.5 µm is studied. The images were captured using a CCD camera and the Boltzmann statistics method was used for force calibration. Using the Hertz model, we calculated and compared the elastic moduli resulting from the lateral force, showing that the differences are important and the force should be considered. Besides the lateral component, the setup also allows us to examine the lateral cell-bead interaction. The mean values of the properties obtained, in particular the elastic stiffness and the shear stiffness, were Eh = (37.76 ± 2.85) µN/m and Gh = (12.57 ± 0.32) µN/m. These results show that the lateral indentation can therefore be used as a routine method for cell study, because it enabled us to manipulate the cell without contact with the laser.展开更多
Eosinophilic esophagitis is a newly recognized disease first described about 50 years ago.The definition,diagnosis,and management have evolved with new published consensus guidelines and newly approved treatment avail...Eosinophilic esophagitis is a newly recognized disease first described about 50 years ago.The definition,diagnosis,and management have evolved with new published consensus guidelines and newly approved treatment available to pediatricians,enabling a better understanding of this disease and more targeted treatment for patients.We describe the definition,presentation,and diagnosis of eosinophilic esophagitis including management,challenges,and future directions in children.The definition,diagnosis,and management of eosinophilic esophagitis have evolved over the last 50 years.Consensus guidelines and newly approved biologic treatment have enabled pediatricians to better understand this disease and allow for more targeted treatment for patients.We describe the definition,presentation,diagnosis,management,and treatment in addition to the challenges and future directions of eosinophilic esophagitis management in children.展开更多
Chronic obstructive pulmonary disease(COPD)accounts for one of the major health and economic burdens worldwide.As a heterogeneous disease,the underlying inflammatory pattern of COPD differs from the previously thought...Chronic obstructive pulmonary disease(COPD)accounts for one of the major health and economic burdens worldwide.As a heterogeneous disease,the underlying inflammatory pattern of COPD differs from the previously thought neutrophil-dominated inflammation,with eosinophilic inflammation occupying approximately one third of stable COPD.Although the eosinophil(EOS)threshold associated with clinical relevance in patients with COPD is currently debated,eosinophil count can be used as a biomarker to guide treatment and to assess the risk of acute exacerbations of COPD,the efficacy of inhaled corticosteroids,and clinical outcomes.The purpose of this review is to describe the biological characteristics of eosinophils and the related research progress as clinical biomarkers.展开更多
文摘BACKGROUND Hepatic eosinophilic pseudotumor(HEPT)is a rare condition that mimics ma-lignant hepatic tumors,posing significant diagnostic challenges.This case report highlights the importance of considering parasitic infections like Fasciola hepatica(F.hepatica)in the differential diagnosis of hepatic masses,especially in endemic regions,to prevent unnecessary interventions.CASE SUMMARY A 40-year-old female presented with a 1-month history of epigastric pain and significant weight loss.Imaging revealed a hepatic mass,initially misdiagnosed as intrahepatic cholangiocarcinoma.Laboratory results showed marked eosinophilia,and histopathological examination confirmed significant eosinophilic infiltration without malignancy.Serological testing identified F.hepatica infection.The patient was treated with a single dose of triclabendazole,leading to complete symptom resolution and normalization of hepatic imaging findings within days.CONCLUSION HEPT due to F.hepatica can closely mimic malignancy;timely antiparasitic treat-ment is crucial for resolution.
文摘BACKGROUND Eosinophilic gastrointestinal(GI)disease(EGID)beyond eosinophilic esophagitis is not commonly reported in the developing world.AIM To estimate the prevalence of EGID in a selected group of pediatric patients suffering from non-functional chronic abdominal pain(CAP).METHODS A retrospective analysis was conducted on case records of children with CAP.Those exhibiting clinical or laboratory alarming features underwent endoscopic evaluation.Histopathology reports from upper GI endoscopy and ileo-colonoscopy determined the diagnosis of EGID.Subsequent analyses included clinical presentations,presence of atopy in the children or family,hemoglobin,albumin,serum immunoglobulin E(IgE),fecal calprotectin levels,endoscopic appearances,treatment methods,and outcomes.RESULTS A total of 368 children with organic CAP were subjected to endoscopic evaluation.Among them,19(5.2%)patients with CAP were diagnosed with EGID.The median age of the children was 11.1 years(interquartile range=8.4-14.4).The estimated prevalence of EGID in children with organic CAP was 520/10000 children over 5 years.Periumbilical pain was the most common site(63%).Family history of atopy,peripheral blood eosinophilia,and elevated serum IgE were the three parameters significantly associated with EGID.Clinical remission was obtained in all children at 6 months.The 47%had microscopic remission and maintained remission until a 1-year follow-up.The 53%had a fluctuating clinical course after 6 months.CONCLUSION EGID beyond the esophagus is not an uncommon entity among the children of India.It can contribute significantly to the etiology of pediatric CAP.
基金funded by National Natural Science Foundation of China(NO.82370083).
文摘Background:Allergic eosinophilic asthma(EA)and eosinophilic granulomatosis with polyangiitis(EGPA)share significant overlaps in both epidemiology and pathogenesis,suggesting a potential link between the two con-ditions.Despite these associations,the underlying molecular and cellular mechanisms driving their connection remain poorly understood.Methods:We retrieved GSE143303 of EA and GSE144302 of EGPA from the GEO database and conducted dif-ferential expression analysis as well as functional enrichment analysis to identify differentially expressed genes(DEGs)and potential pathogenic pathways.A protein-protein interaction(PPI)network was generated using the STRING database.Key hub genes were determined through cytoHubba.We added two publicly reported EA and EGPA-related transcriptome datasets,GSE117038 and GSE119136,for mutual verification.Subsequent valida-tion was performed via immune infiltration assessment utilizing CIBERSORT.Results:In total,267 DEGs were identified,in which HSP90AA1,HSPA8,CCND1,RPS20,CD74,RPL5,RPS6,RHOA,RPS3A and FLT3LG are the top 10 hub genes,while the antigen processing and presentation pathway and leukocyte cell-cell adhesion pathway were the potential influential pathways.Increased naïve B cells and M1 type of Macrophages were detected in EA patients through immune infiltration analysis.Conclusions:Utilizing bioinformatics techniques,this study is the initial investigation to uncover the shared mechanisms involving the antigen processing and presentation pathway and leukocyte adhesion pathways in the progression of both EA and EGPA.It may offer potential biomarkers for future studies on the underlying path-ogenesis and treatment of EA and EGPA as well as eosinophilia related co-morbidities.
基金supported by the National High-Level Hospital Clinical Research Funding(2022-PUMCH-D-002).
文摘Background:Hypereosinophilia(HE)is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor.This case report presents the course and prognosis of a patient with hypereosinophilia treated with suplatast tosilate monotherapy.Case presentation:A 41-year-old female patient who complained of“Elevated blood eosinophils were found during physical examination for more than 2 months”visited the Allergy Department.The systematic screening results of parasites,autoantibodies spectrum,tumor markers,peripheral blood morphology analysis,and leukemia fusion gene(FIP1L1-PDGFRα)were all negative.Gastrointestinal endoscopy only indicated mild gastritis.The dust mites and multiple fungal mixtures were weakly positive in intradermal tests.Finally diagnosed HE.After treatment with suplatast tosilate 2 months of 100mg three times daily,the blood eosinophils decreased to normal.Then,maintenance treatment with 50mg three times a day for 3 months.And without recurrence during nearly five years of follow-up.Conclusion:The report indicates that suplatast tosilate can reduce peripheral blood eosinophils levels in patients with HE,and may be a reliable option for individualized treatment of HE.However,there is still no consensus on whether suplatast tosilate can be used as a first-line treatment or as an adjuvant therapy to reduce the corticosteroids dosage for patients with eosinophilia,and further research is needed.
基金supported by the National Natural Science Foundation of China(No.82070200)。
文摘Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and females equally,though males may exhibit more active disease at diagnosis and often require more aggressive treatment(Liu et al.,2023).The hallmark features of EGPA include delayed-onset asthma,eosinophilia in tissues and blood,and vasculitis affecting small to medium-sized arteries(White and Dubey,2023).EGPA falls under the category of antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),whereas only about half of EGPA patients test positive for ANCA(Khoury et al.,2023).
基金supported by NIH grants to M Bukrinsky P30 AI117970by the“Creation of Experimental Laboratories in the Natural Sciences Program”and Basic Research Program at the Higher School of Economics University.
文摘Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of inflammatory responses.The most prevalent chronic inflammatory illness,rheumatoid arthritis(RA),is typified by persistent synovitis thatmakes it hard for the disease to go away on its own.Interestingly,a unique subset of eosinophils known as regulatory eosinophils has been found in RA patients’synovium,especially while the disease is in remission.Pro-resolving signatures of regulatory eosinophils in the synovium are distinct from those of their lung counterparts.The most recent research on eosinophils and their function in this disease pathogenesis is compiled in this review.Based on the role of regulatory eosinophils,a new pathological model of inflammation resolution in RA is proposed,and potential therapeutic strategies aimed at enhancing the action of regulatory eosinophils in RA are proposed.
文摘Eosinophilic myocarditis(EM)is a rare inflammatory condition of the heart,often associated with eosinophilic infiltration.While its causes range from allergies to autoimmune and infectious diseases,parasitic infections are an uncommon but critical etiology.This mini-review focuses on a case of EM in a 47-year-old male from Vietnam,linked to Schistosoma spp.,Strongyloides stercoralis,and Toxocara spp.infections.The patient presented with severe chest pain and recovered fully after treatment with corticosteroids and albendazole.Drawing insights from this case and existing literature,we discuss the pathophysiology,diagnostic approaches,and therapeutic strategies for parasite-induced EM.Early diagnosis and tailored treatment are essential to improve clinical outcomes,especially in endemic para-sitic areas.
文摘BACKGROUND Eosinophilic esophagitis(EoE)is a chronic inflammatory disorder presenting as symptoms of dysphagia,esophageal food impaction,chest pain,and heartburn.After an initial trial of proton pump inhibitor(PPI)therapy,swallowed topical corticosteroids(STC)are effective as induction therapy for EoE.However,out-come data for STC as a maintenance strategy is limited.RESULTS Three randomized control trials and one observational study were included,involving 303 patients(189 in the STC group,114 in the placebo-controlled group).Analysis showed that histologic recurrence was significantly lower with STC(OR:0.04,95%CI:0.01-0.28,P<0.00001,I^(2)=78%).Overall symptom recurrence was similar between groups(OR:0.23,95%CI:0.02-3.54,P=0.29,I^(2)=92%).On sensitivity analysis,symptom recurrence was significantly lower in the STC group(OR:0.05,95%CI:0.02-0.17,P=0.00001,I^(2)=39%).Odds of repeat dilation were significantly lower in the STC group(OR:0.14,95%CI:0.02-0.91,P=0.04,I^(2)=0%).Candida infection rates were similar between groups(OR:6.13,95%CI:0.85-44.26,P=0.07,I^(2)=24%).Proportion of concomitant PPI use was similar between groups(OR:1.64,95%CI:0.83-3.21,P=0.15,I^(2)=0%).CONCLUSION For patients who successfully achieved remission of EoE with STC induction therapy,maintaining treatment is effective in sustaining histologic remission,while newer regimens may be effective in preventing symptom recurrence compared to placebo.We found no significant difference for oropharyngeal/esophageal candidiasis with STC maintenance therapy.Future studies with longer follow-up periods are needed.
基金supported by the National Natural Science Foundation of China (Grant nos. 82470209 and 82170141)the Jiaxing Key Discipiline of Medcine-Nephrology (Grant no. 2023-ZC-011)。
文摘Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predict NDMM patient outcomes. The Durie-Salmon (D-S) staging system reflects tumor burden and clinical progression staging with prognostic value.
文摘Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.
基金supported by Clinical Research Operating Fund of Central High Level Hospitals(2022-PUMCH-D-002).
文摘Introduction:Eosinophilia is a rare disease characterized by an increase in eosinophils.Suplatast tosilate is a selective Th2 cytokine inhibitor that can reduce eosinophils.There is currently a lack of clinical studies of suplatast tosilate in the treatment of eosinophilia.Research objective:To explore whether suplatast tosilate can reduce blood eosinophil levels in eosinophilia and the factors that might influence the improvement.Methods:A real-world retrospective study of 20 patients with eosinophilia was conducted using electronic medical record information.The main outcome measure was the difference in peripheral blood absolute eosinophil count(AEC)and percentage(EOS%)before suplatast tosilate(baseline)and the lowest AEC during the 1-year period of suplatast tosilate treatment(post-treatment).Data on age,gender,disease duration,involved organs,and concomitant medication were collected,and subgroup analysis and linear regression analysis were performed.Results:Subjects were predominantly male,with a mean age of 33 years and a disease duration of approximately 30 months.After treatment with suplatast tosilate,the patient's AEC(p=0.029)and EOS%(p=0.016)significantly decreased.The decline in eosinophils was more pronounced in patients who were male,age<33 years,disease duration<30 months and gastrointestinal system involvement.In addition,the shorter the course of the disease,the greater the relative decrease in eosinophils after suplatast tosilate treatment(β=-0.018,p<0.001).Conclusions:Suplatast tosilate is effective in reducing peripheral blood eosinophil levels in patients with eosinophilia.Large-scale prospective cohort studies are needed for further confirmation.
基金National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003and Undergraduate Innovation Program,No.2023zglc06076.
文摘BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.
文摘Eosinophilic gastroenteritis (EG) is an uncommon disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract, and is usually associated with dyspepsia, diarrhea and peripheral eosinophilia. Diffuse gastrointestinal tract and colonic involvement are uncommon. The endoscopic appearance may vary from normal to mucosal nodularity and ulceration. Gastrointestinal obstruction is unusual and is associated with predominantly muscular disease. We present five unusual cases of EG associated with gastric outlet and duodenal obstruction. Two cases presented with acute pancreatitis and one had a history of pancreatitis. Four cases responded well to medical therapy and one had recurrent gastric outlet obstruction that required surgery. Four out of the five cases had endoscopic and histological evidence of esophagitis and two had colitis. Two patients had ascites. These cases reaffirm that EG is a disorder with protean manifestations and may involve the entire gastrointestinal tract. Gastric outlet and/or small bowel obstruction is an important though uncommon presentation of EG. It may also present as esophagitis, gastritis with polypoid lesions, ulcers or erosions, colitis and pancreatitis and may mimic malignancy.
文摘Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level.
文摘Eosinophilic gastroenteritis (EGE) in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often,the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion,including parasitic infections and drug-induced causes. Occasionally,the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized,in large part,due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea,in particular,endoscopic imaging and mucosal biopsies. Def inition of EGE,however,may be diffi cult,as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also,the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms,and,in some instances,eosinophil quantification in pre-treatment and post-treatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in defi nition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.
基金supported by Natural Science Foundation of Hubei Province(2021CFB401)。
文摘Eosinophilic oesophagitis(EoE)is an allergen/immune-mediated chronic esophageal disease characterized by esophageal mucosal eosinophilic infiltration and esophageal dysfunction.Although the disease was originally attributed to a delayed allergic reaction to allergens and a Th2-type immune response,the exact pathogenesis is complex,and the efficacy of existing treatments is unsatisfactory.Therefore,the study of the pathophysiological process of EOE has received increasing attention.Animal models have been used extensively to study the molecular mechanism of EOE pathogenesis and also provide a preclinical platform for human clinical intervention studies of novel therapeutic agents.To maximize the use of existing animal models of EOE,it is important to understand the advantages or limitations of each modeling approach.This paper systematically describes the selection of experimental animals,types of allergens,and methods of sensitization and excitation during the preparation of animal models of EoE.It also discusses the utility and shortcomings of each model with the aim of providing the latest perspectives on EoE models and leading to better choices of animal models.
文摘BACKGROUND Eosinophilic solid and cystic(ESC)renal cell carcinoma(RCC),a unique and emerging subtype of RCC,has an indolent nature;in some rare instances,it may exhibit metastatic potential.Current cases are inadequate to precisely predict the clinical outcome of ESC RCC and determine treatment choices.CASE SUMMARY Herein,we report two patients with ESC RCC.Patient 1 was a young woman with classical pathological characteristics.Patient 2 was a 52-year-old man with multifocal metastases,involving the pulmonary hilar and mediastinal lymph nodes,liver,brain,mesosternum,vertebra,rib,femur,and symphysis pubis.Awareness of ESC RCC,along with its characteristic architecture and immunophenotype,would contribute to making a definitive diagnosis,even on core biopsy samples.CONCLUSION The discovery of ESC RCC molecular signatures may provide new therapeutic strategies in the future.
文摘In this work, lateral deformation of human eosinophil cell during the lateral indentation by an optically trapped microbead of diameter 4.5 µm is studied. The images were captured using a CCD camera and the Boltzmann statistics method was used for force calibration. Using the Hertz model, we calculated and compared the elastic moduli resulting from the lateral force, showing that the differences are important and the force should be considered. Besides the lateral component, the setup also allows us to examine the lateral cell-bead interaction. The mean values of the properties obtained, in particular the elastic stiffness and the shear stiffness, were Eh = (37.76 ± 2.85) µN/m and Gh = (12.57 ± 0.32) µN/m. These results show that the lateral indentation can therefore be used as a routine method for cell study, because it enabled us to manipulate the cell without contact with the laser.
文摘Eosinophilic esophagitis is a newly recognized disease first described about 50 years ago.The definition,diagnosis,and management have evolved with new published consensus guidelines and newly approved treatment available to pediatricians,enabling a better understanding of this disease and more targeted treatment for patients.We describe the definition,presentation,and diagnosis of eosinophilic esophagitis including management,challenges,and future directions in children.The definition,diagnosis,and management of eosinophilic esophagitis have evolved over the last 50 years.Consensus guidelines and newly approved biologic treatment have enabled pediatricians to better understand this disease and allow for more targeted treatment for patients.We describe the definition,presentation,diagnosis,management,and treatment in addition to the challenges and future directions of eosinophilic esophagitis management in children.
文摘Chronic obstructive pulmonary disease(COPD)accounts for one of the major health and economic burdens worldwide.As a heterogeneous disease,the underlying inflammatory pattern of COPD differs from the previously thought neutrophil-dominated inflammation,with eosinophilic inflammation occupying approximately one third of stable COPD.Although the eosinophil(EOS)threshold associated with clinical relevance in patients with COPD is currently debated,eosinophil count can be used as a biomarker to guide treatment and to assess the risk of acute exacerbations of COPD,the efficacy of inhaled corticosteroids,and clinical outcomes.The purpose of this review is to describe the biological characteristics of eosinophils and the related research progress as clinical biomarkers.
