Eosinophil-targeted treatment strategies for long-term outcomes in severe eosinophilic asthma

Airway eosinophilic inflammation is a key pathobiologic trait of severe asthma, a complex chronic disease which affects about 5-10% of asthmatic patients worldwide. Therefore, an in-depth knowledge of the immunopathologic mechanisms underlying severe eosinophilic asthma (SEA) is essential to understand the beneficial effects of currently available, eosinophil-targeted anti-asthma treatments, as well as to develop new therapeutic strategies. This narrative review article aims to provide a concise coverage of the pathophysiology of severe eosinophilic asthma, followed by an updated overview of current and newly emerging therapeutic approaches capable of counteracting airway eosinophilic inflammation. All information reported comes from an extensive literature search conducted on PubMed. The recent advances regarding our understanding of the proinflammatory pathways characterizing the various SEA endotypes are allowing to shape effective therapeutic options, driven by the accurate selection of relevant molecular targets. Such successful developments are at the basis of the sustained clinical remission of eosinophilic asthma, which today represents a realistic goal for many severe asthmatic patients.