Abstract

Case Report

Eosinophilic otitis media and eosinophilic asthma: Shared pathophysiology and response to anti-IL5

Marieke T Drijver-Messelink*, Mariette Wagenaar, Jacqueline van der Meij and Anneke ten Brinke

Published: 04 June, 2019 | Volume 3 - Issue 1 | Pages: 009-012

Asthma is a highly prevalent airway disease with multiple phenotypes [1,2]. Adult-onset eosinophilic asthma is a severe asthma subtype associated with more frequent and severe exacerbations, the development of persistent airflow limitation and a poorer quality of life. This type of asthma is much more difficult to control than other asthma subtypes, requiring high doses of inhaled or even oral corticosteroids (OCS) [3,4]. Recently, several new monoclonal antibody therapies have been approved for eosinophilic severe asthma, including anti-IL-5 treatment. IL-5 is essential for eosinophilic maturation and survival [5] and anti-IL5 treatment has markedly reduced asthma exacerbations with sparing of OCS use in patients with eosinophilic asthma [6]. Eosinophilic asthma is frequently associated with chronic rhinosinusitis and/or nasal polyposis [7], suggesting that a similar eosinophilic inflammatory process might drive both conditions. Eosinophilic otitis media (EOM) also might fit in this concept, showing remarkable similarities with asthma and nasal polyposis. The disease was first reported in 1994, but only since 2011 diagnostic criteria for EOM were identified. If a patient shows otitis media with effusion or chronic otitis media with eosinophil-dominant effusion (major criterion) and is being positive for ≥2 items of the 4 minor criteria (highly viscous middle ear effusion, resistance to conventional treatment, association with asthma, association with nasal polyposis) he is diagnosed as having EOM. Eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome must be excluded [8].

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References

  1. Wenzel SE. Asthma: defining of the persistent adult phenotypes. Lancet. 2006; 368(9537): 804-813. Ref.: https://bit.ly/2WAWGAQ
  2. Anderson GP. Endotyping asthma: new insights into key pathogenic mechanisms in a complex, heterogeneous disease.2008; 372(9643): 1107-1119. Ref.: https://bit.ly/2QCRxTe
  3. de Groot JC, Ten Brinke A, Bel EH. Management of the patient with eosinophilic asthma: a new era begins. ERJ Open Res. 2015; 1. Ref.: https://bit.ly/2Mqurkg
  4. de Groot JC, Storm H, Amelink M, de Nijs SB, Eichhorn E, et al. Clinical profile of patients with adult-onset eosinophilic asthma. ERJ Open Res. 2016; 2: 00100-2015. Ref.: https://bit.ly/2KnQohx
  5. Russell R, Brightling CE. Anti-IL-5 for Severe Asthma: Aiming High to Achieve Success. Chest. 2016; 150: 766-768. Ref.: https://bit.ly/2XmSWQD
  6. Bel EH, ten Brinke A. New Anti-Eosinophil Drugs for Asthma and COPD. Targeting the trait! Chest. 2017; 152: 1276-1282. Ref.: https://bit.ly/2Wqtnlm
  7. van der Meer AN, ten Brinke A. Nasal polyposis and asthma: the chest physician’s view. In: Bachert C, Bourdin A, Chanez P, eds. The Nose and Sinuses in Respiratory Disorders (ERS Monograph). Sheffield, European Respiratory Society. 2017; 105–121. Ref.: https://bit.ly/2WlP4ms
  8. Iino Y, Tomioka-Matsutani S, Matsubara A, Nakagawa T, Nonaka M. Diagnostic criteria of eosinophilic otitis media, a newly recognized middle ear disease. Auris Nasus Larynx. 2011; 38: 456-461. Ref.: https://bit.ly/2If8QGp
  9. Ueki S, Ohta N, Takeda M, Konno Y, Hirokawa M. Eosinophilic Otitis Media: the Aftermath of Eosinophil Extracellular Trap Cell Death. Curr Allergy Asthma Rep. 2017; 17:33. Ref.: https://bit.ly/2QHSARQ

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