嗜酸性粒细胞(Eos)在哮喘的发病机制中起着重要作用，是过敏性炎症反应重要的效应细胞，同时也起到了抗原呈递的作用。近年来研究指出Eos可以进一步进行亚群分析，有助于精准医疗。气道嗜酸性炎症直接评估方法包括活组织检查、肺泡灌洗和诱导痰化验。目前，临床上通常可采用血Eos计数及呼出气一氧化氮代替诱导痰化验作为诊断指标。此外，新型生物标志物如骨膜蛋白、神经毒素、细胞外陷阱等或可用于哮喘的诊疗指导和预后预测。靶向Eos的生物制剂也处于研究中，其中白细胞介素(IL)-5制剂已被美国进行采用，拓宽了哮喘治疗的范围。本文就Eos在哮喘诊疗中的研究进展进行综述，使临床工作者进一步了解哮喘的发生发展机制，更精准地识别Eos型哮喘患者，并为其中不能受益于传统治疗方式的哮喘患者提供新的治疗选择。

[1] 王德兵,唐玉红,翟传华,等.儿童支气管哮喘合并过敏性鼻炎的影响因素及临床干预[J].现代医学,2022,50(10):1338-1342.
[2] The Global Asthma Report 2022[J].Int J Tuberc Lung Dis,2022,26(Supp1):1-104.
[3] 林慧敏,符昱,方章福,等.嗜酸性粒细胞哮喘的研究进展[J].结核与肺部疾病杂志,2022,3(4):328.
[4] NOVOSAD J,KRČMOVÁ I,SOUČEK O,et al.Subsets of eosinophils in asthma,a challenge for precise treatment[J].Int J Mol Sci,2023,24(6):5716.
[5] WECHSLER M E,MUNITZ A,ACKERMAN S J,et al.Eosinophils in health and disease:a state-of-the-art review[J].Mayo Clin Proc,2021,96(10):2694-2707.
[6] FUKUDA T,GLEICH G.Heterogeneity of human eosinophils[J].J Allergy Clin Immunol,1989,83(2):369-373.
[7] ABDALA VALENCIA H,LOFFREDO L,MISHARIN A,et al.Phenotypic plasticity and targeting of Siglec-F high CD11c low eosinophils to the airway in a murine model of asthma[J].Allergy,2016,71(2):267-271.
[8] PERCOPO C,BRENNER T,MA M,et al.SiglecF+Gr1hi eosinophils are a distinct subpopulation within the lungs of allergen-challenged mice[J].J Leukoc Biol,2017,101(1):321-328.
[9] MESNIL C,RAULIER S,PAULISSEN G,et al.Lung-resident eosinophils represent a distinct regulatory eosinophil subset[J].J Clin Inves,2016,126(9):3279-3295.
[10] VAN HULST G,BUREAU F,DESMET C J.Eosinophils as drivers of severe eosinophilic asthma:endotypes or plasticity?[J].Int J Mol Sci,2021,22(18):10150.
[11] CHOI B.Eosinophils and childhood asthma[J].Clin Exp Pediatr,2021,64(2):60-67.
[12] 张亚丽,蒋毅.诱导痰检测技术在支气管哮喘中的应用进展[J].山东医药,2022,62(7):93-96.
[13] 雒志明,高赏,任魁,等.支气管哮喘患者外周血嗜酸性粒细胞计数与诱导痰嗜酸性粒细胞百分比和呼出气一氧化氮的相关性[J].山西医科大学学报,2017,48(10):1039-1043.
[14] LEHTIMÄKI L,SHRIMANKER R,MORAN A,et al.P13 Exhaled nitric oxide and blood eosinophil count in predicting sputum inflammatory type in a heterogeneous airways disease population[J].Thorax,2019,74(Suppl 2):A95.
[15] 徐敏,胡田勇,邱书奇,等.哮喘相关生物标记物的研究进展[J].广东医学,2021,42(3):254-259.
[16] 刘勇,刘丹,柴文戍.血IL-1β,IL-18,Eos水平与支气管哮喘急性发作病情程度的关系及对近期转归的预测效能探讨[J].东南大学学报(医学版),2022,41(4):464-470.
[17] HABIB N,PASHA M A,TANG D D.Current understanding of asthma pathogenesis and biomarkers[J].Cells,2022,11(17):2764.
[18] KHATRI S,IACCARINO J,BAROCHIA A,et al.Use of fractional exhaled nitric oxide to guide the treatment of asthma:an official American thoracic society clinical practice guideline[J].Am J Respir Crit Care Med,2021,204(10):e97-e109.
[19] DIAMANT N,AMIRAV I,ARMONI-DOMANY K,et al.High fractional exhaled nitric oxide levels in asthma patients:does size matter?[J].Pediatr Pulmonol,2021,56(6):1449-1454.
[20] COUILLARD S,SHRIMANKER R,CHAUDHURI R,et al.Fractional exhaled nitric oxide nonsuppression identifies corticosteroid-resistant type 2 signaling in severe asthma[J].Am J Respir Crit Care Med,2021,204(6):731-734.
[21] 程丽,蒋毅,岳倩如,等.呼出气一氧化氮和外周血嗜酸粒细胞计数对嗜酸粒细胞型哮喘的诊断价值[J].中华全科医师杂志,2020,19(6):502-506.
[22] 徐敏,胡田勇,邱书奇,等.哮喘相关生物标记物的研究进展[J].广东医学,2021,42(3):254-259.
[23] O'DWYER D N,MOORE B B.The role of periostin in lung fibrosis and airway remodeling[J].Cell Mol Life Sci,2017,74:4305-4314.
[24] JIA G,ERICKSON R,CHOY D,et al.Periostin is a systemic biomarker of eosinophilic airway inflammation in asthmatic patients[J].J Allergy Clin Immunol,2012,130(3):647-654.e10.
[25] TAKAHASHI K,MEGURO K,KAWASHIMA H,et al.Serum periostin levels serve as a biomarker for both eosinophilic airway inflammation and fixed airflow limitation in well-controlled asthmatics[J].J Asthma,2019,56(3):236-243.
[26] KIM C K,CALLAWAY Z,PARK J S,et al.Utility of serum eosinophil-derived neurotoxin(EDN) measurement by ELISA in young children with asthma[J].Allergol Int,2017,66(1):70-74.
[27] RUTTEN B,YOUNG S,RHEDIN M,et al.Eosinophil-derived neurotoxin:a biologically and analytically attractive asthma biomarker[J].PLoS One,2021,16(2):e0246627.
[28] LUU QUOC Q,MOON J,LEE D,et al.Role of thymus and activation-regulated chemokine in allergic asthma[J].J Asthma Allergy,2022,15:157-167.
[29] AN J,LEE J-H,SIM J H,et al.Serum eosinophil-derived neurotoxin better reflect asthma control status than blood eosinophil counts[J].J Allergy Clin Immunol Pract,2020,8(8):2681-2688.e1.
[30] KIM H,YANG H,SONG D,et al.Eosinophil-derived neurotoxin:an asthma exacerbation biomarker in children[J].Allergy Asthma Proc,2022,43(2):133-139.
[31] SIMON D,SIMON H U,YOUSEFI S.Extracellular DNA traps in allergic,infectious,and autoimmune diseases[J].Allergy,2013,68(4):409-416.
[32] CHOI Y,LUU Q,PARK H.Extracellular traps:a novel therapeutic target for severe asthma[J].J Asthma Allergy,2022,15:803-810.
[33] LU Y,HUANG Y,LI J,et al.Eosinophil extracellular traps drive asthma progression through neuro-immune signals[J].Nat Cell Biol,2021,23(10):1060-1072.
[34] GAI X Y,ZHANG L J,CHANG C,et al.Metabolomic analysis of serum glycerophospholipid levels in eosinophilic and neutrophilic asthma[J].Biomed Environ Sci,2019,32(2):96-106.
[35] HUANG F,YU J,LAI T,et al.The combination of bioinformatics analysis and untargeted metabolomics reveals potential biomarkers and key metabolic pathways in asthma[J].Metabolites,2022,13(1):25.
[36] HARVEY E S,LANGTON D,KATELARIS C,et al.Mepolizumab effectiveness and identification of super-responders in severe asthma[J].Eur Respir J,2020,55(5):1902420.
[37] GIBSON P,PRAZMA C,CHUPP G,et al.Mepolizumab improves clinical outcomes in patients with severe asthma and comorbid conditions[J].Respir Res,2021,22(1):171.
[38] DOMINGO RIBAS C,CARRILLO DÍAZ T,BLANCO APARICIO M,et al.Real world effectiveness and safety of mepolizumab in a multicentric Spanish cohort of asthma patients stratified by eosinophils:the REDES study[J].Drugs,2021,81:1763-1774.
[39] BJERMER L,LEMIERE C,MASPERO J,et al.Reslizumab for inadequately controlled asthma with elevated blood eosinophil levels:a randomized phase 3 study[J].Chest,2016,150(4):789-798.
[40] CASTRO M,MATHUR S,HARGREAVE F,et al.Reslizumab for poorly controlled,eosinophilic asthma:a randomized,placebo-controlled study[J].Am J Respir Crit Care Med,2011,184(10):1125-1132.
[41] SINGH D,FUHR R,BIRD N,et al.A Phase 1 study of the long-acting anti-IL-5 monoclonal antibody GSK3511294 in patients with asthma[J].Br J Clin Pharmacol,2022,88(2):702-712.
[42] KOLBECK R,KOZHICH A,KOIKE M,et al.MEDI-563,a humanized anti-IL-5 receptor alpha mAb with enhanced antibody-dependent cell-mediated cytotoxicity function[J].J Allergy Clin Immunol,2010,125(6):1344-1353.e2.
[43] LAVIOLETTE M,GOSSAGE D,GAUVREAU G,et al.Effects of benralizumab on airway eosinophils in asthmatic patients with sputum eosinophilia[J].J Allergy Clin Immunol,2013,132(5):1086-1096.e5.
[44] KAVANAGH J,HEARN A,DHARIWAL J,et al.Real-world effectiveness of benralizumab in severe eosinophilic asthma[J].Chest,2021,159(2):496-506.
[45] CUSHEN B,MENZIES-GOW A.Benralizumab:an updated treatment of eosinophilic asthma[J].Expert Rev Respir Med,2020,14(5):435-444.
[46] BOCHNER B S.“Siglec” ting the allergic response for therapeutic targeting[J].Glycobiology,2016,26(6):546-552.
[47] O'SULLIVAN J,CHANG A,YOUNGBLOOD B,et al.Eosinophil and mast cell Siglecs:from biology to drug target[J].J Leukoc Biol,2020,108(1):73-81.
[48] ANESI S,TAUBER J,NGUYEN Q,et al.Lirentelimab for severe and chronic forms of allergic conjunctivitis[J].J Allergy Clin Immunol,2022,150(3):631-639.
[49] VAN HULST G,BATUGEDARA H M,JORSSEN J,et al.Eosinophil diversity in asthma[J].Biochem Pharmacol,2020,179:113963.