Eosinophilic Asthma: What It Is and Why It’s Unique

Asthma refers to a group of chronic diseases affecting the respiratory system. Estimates suggest that over 25.7 million Americans have asthma, with approximately 15% dealing with severe symptoms.

Among the different forms, eosinophilic asthma stands out as a rarer, more severe condition, impacting around 5% of adults. It is characterized by elevated eosinophil levels — white blood cells that combat infections — which, when abnormally high, lead to airway inflammation.

This inflammation obstructs nasal passages and causes typical asthma symptoms like breathing difficulties. The severity of the symptoms is closely linked to eosinophil concentration. If untreated, chronic inflammation can cause irreversible damage. Since its presentation may mimic chronic obstructive pulmonary disease (COPD), an accurate diagnosis is vital for effective treatment.

Symptoms of Eosinophilic Asthma

• Breathing difficulty

• Chest pressure

• Wheezing sounds

• Chronic coughing

• Restricted airflow

• Nasal stuffiness

• Drainage from the nose

• Recurring sinus infections

• Impaired sense of smell

• Formation of nasal polyps

• Abnormal lung function tests

• Swelling of the nasal lining

Differences Between Eosinophilic Asthma and Other Asthma Forms

• Eosinophilic asthma typically affects adults, while other forms may present in children as well.

• Unlike allergic asthma, it is not immediately triggered by allergens like pet dander or pollen.

• Breathlessness is the hallmark symptom, rather than wheezing, common in other types.

Treatment Approaches for Eosinophilic Asthma

1. Inhaled corticosteroids: Maintain open airways and prevent flare-ups.

2. Oral corticosteroids: Used when inhalers are insufficient.

3. Bronchodilators: Provide quick relief by relaxing airway muscles.

4. Leukotriene modifiers: Mitigate asthma triggers within the immune system.

5. Biologic therapies: Target inflammation at a cellular level.

6. Bronchial thermoplasty: A specialized therapy using heat to reduce airway muscle mass.

Common Eosinophilic Asthma Triggers

• Mold spores

• Certain medications like aspirin

• Allergenic foods (e.g., peanuts, seafood)

• Animal fur and dander

• Pollen exposure

• Smoke and pollution

• Extreme temperature variations

• Strong-smelling cleaning agents

• Vigorous physical activities

• Emotional outbursts or intense emotions

Self-Management Tips for Patients

• Know and avoid your specific triggers.

• Keep a balanced weight.

• Engage in moderate, doctor-approved exercise.

• Get vaccinated against influenza annually.

• Track food-related asthma triggers.

• Refrain from smoking.

• Ensure pets are groomed and kept out of bedrooms.

• Reduce exposure to airborne allergens.