Some people also refer to eosinophilic asthma as “e-asthma” or “eos asthma.”
Eosinophilic asthma appears alongside high levels of eosinophils in your airways. These eosinophils cause inflammation, leading to asthma symptoms.
Knowing your asthma type can be important, as it may have different triggers, development, and treatment approaches.
Talk with a doctor if you have any questions about eosinophilic asthma.
This article discusses key facts about eosinophilic asthma, including essential information about its causes, treatment, and presentation.
Quick facts about eosinophilic asthma
- Eosinophilic asthma is a type of severe asthma.
- Like other types of asthma, eosinophilic asthma causes symptoms such as wheezing, shortness of breath, and chest tightness.
- The exact cause of asthma, including eosinophilic asthma, is unknown.
- Treatment for eosinophilic asthma can include corticosteroids, biologic medications, and leukotriene modifier medications.
1. Eosinophilic asthma differs from other asthma types
Doctors categorize asthma into types depending on differences in their biological features and triggers:
- Allergic asthma: Allergies like pollen and pet dander trigger this type of asthma.
- Non-allergic asthma: Non-allergic asthma occurs when triggers that aren’t allergens provoke asthma symptoms. Non-allergen triggers include respiratory infections and stress.
- Eosinophilic asthma: Eosinophilic asthma is a rare type of asthma caused by your body producing too many eosinophils.
- Non-eosinophilic asthma: This is when you have asthma with low levels of eosinophils.
- Neutrophilic asthma: Neutrophilic asthma is a subtype of non-eosinophilic asthma. With this asthma, you have low levels of eosinophils and high levels of white blood cells called neutrophils.
Experts also divide asthma types into two groups that describe their immune processes and response to treatment:
- Type 2 inflammation: Allergic and eosinophilic asthma cause type 2 inflammation. They may improve with inhaled corticosteroids and biologic medications.
- Non-type 2 inflammation: This includes non-eosinophilic asthma. Non-type 2 inflammation asthma may not respond as well to inhaled corticosteroids.
Learn more about allergic asthma, including its symptoms and treatment.
2. Eosinophilic asthma is linked to high levels of certain white blood cells
Eosinophilic asthma occurs when your asthma appears alongside high levels of eosinophils in your airways.
Eosinophils are a key part of your immune system, helping to manage infections and foreign substances. However, high levels of eosinophils may lead to excess inflammation, causing asthma symptoms.
3. The exact cause of eosinophilic asthma is unknown
Experts know of many asthma triggers and certain biological processes that contribute to asthma, such as high levels of eosinophils.
More research is needed to know why asthma develops in the first place and what causes high levels of eosinophils. Experts currently believe that your genetic predisposition and exposure to environmental triggers like allergens and infection may play a role.
Learn more about eosinophilic asthma, including its possible causes.
4. Eosinophilic asthma may have different triggers
People with eosinophilic asthma don’t often have allergies, so allergens may not be a common trigger. However, this can vary, and some people notice that allergies do contribute to their asthma. Examples of allergens include:
- pollen and grass
- dust and dust mites
- pet dander
- mold
Other irritants that aren’t allergens may trigger eosinophilic asthma more often, such as:
- respiratory infection
- weather conditions
- air pollution or other particles in the air
- medications and other substances
- stress
- food additives
- physical activity
- smoke
- strong odors or chemicals
5. Eosinophilic asthma often develops in adulthood
Asthma frequently starts in childhood. However, eosinophilic asthma most often appears for the first time in adulthood, between the ages of 35 and 50.
Doctors may refer to this as adult-onset asthma.
6. Doctors can diagnose eosinophilic asthma with specific tests
Medical professionals can spot eosinophilic asthma by running tests to check your eosinophil levels and other signs of the condition, such as:
- blood tests
- mucus or saliva tests
- a nitric oxide gas test, which involves you breathing into a mouthpiece and device to check inflammation levels
7. Eosinophils link to about half of the cases of severe asthma
Eosinophilic asthma is often severe. For example, it tends to:
- cause frequent asthma attacks
- have an increased need for oral corticosteroid medications
- need specialized treatment, as it may not respond well to standard approaches like inhaled corticosteroids
- link to further effects or complications, such as rhinosinusitis, nasal polyps, and persistent inflammation
Experts estimate that around half of severe asthma cases are eosinophilic asthma.
Find out more about the link between asthma and nasal polyps.
Also learn about asthma complications and how to manage them.
8. There are new treatment options for eosinophilic asthma
Response to asthma treatments can vary for each person. Some people experience improvements in their eosinophilic asthma with standard approaches, like inhaled corticosteroids, while others don’t.
Many other treatments can help improve eosinophilic asthma, including newer medications called biologics. They work by targeting specific cells and substances that cause inflammation.
Biologic medications that particularly help eosinophilic asthma include:
- benralizumab (Fasenra)
- mepolizumab (Nucala)
- reslizumab (Cinqair)
- tezepelumab (Tezspire)
Other treatments may also help, such as medications called leukotriene modifiers. Leukotriene modifiers can block chemicals that contribute to airway inflammation.
Talk with a doctor if you have any questions about eosinophilic asthma treatment.
Read more about biologic medications for severe asthma and treating severe asthma.
Meredith Goodwin MD, FAAFP, has also reviewed the following frequently asked questions.
What triggers eosinophilic asthma?
Triggers for eosinophilic asthma often include non-allergenic triggers, such as infections, weather conditions, certain food additives, and stress.
Allergies to certain substances can trigger eosinophilic asthma, such as pollen, dust, and animal allergies. However, this is less common.
Is eosinophilic asthma worse than other asthma?
While all asthma types can become serious, eosinophilic asthma is often considered more severe. This is because eosinophilic asthma can cause more frequent asthma attacks and doesn’t always respond well to inhaled corticosteroids.
How do you live with eosinophilic asthma?
The best way to manage eosinophilic asthma in daily life is to take your medical treatment as prescribed, alongside practicing self-care.
Self-care that may help asthma and support a good quality of life can include:
- keeping a symptom and activity diary to identify triggers
- managing stress, such as with meditation or counseling
- staying up to date with vaccinations
- getting regular physical activity
- eating a balanced diet
- taking an asthma self-management class
- talking about any concerns with a medical professional
Eosinophilic asthma occurs when high levels of white blood cells, eosinophils, are present in your airways, causing asthma symptoms.
It is a type of severe asthma, as it tends to cause frequent asthma attacks and doesn’t always respond to inhaled corticosteroids. However, biologic medications and other approaches can help improve symptoms.
While the cause of eosinophilic asthma is unknown, researchers have identified its possible triggers. Examples include allergies and other irritations, such as infections, stress, and pollution.
Talk with a doctor if you have any questions about your asthma type.