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Reduction/elimination of blood eosinophils in severe asthma: should there be a safety consideration?
Published in Expert Opinion on Biological Therapy, 2022
Konstantinos Katsoulis, Maria Kipourou, Stelios Loukides
Two kinds of stimuli are required for the eosinophil production in the bone marrow: transcription factors and cytokines (Figure 1). Multiple transcription factors (including C-Enhancer binding Protein ε-C/ EBPε, GATA-1 and PU.1) need to be expressed so that the eosinophilic progenitor (EoP) is produced from the pluripotent CD34+ stem cells [9,10]. Moreover, production of the eosinophils is crucially dependent on the appearance of the specific receptor for the cytokine IL-5 (IL-5 R) on the surface of the hematopoietic precursor [9]. IL-5 is a cytokine of major importance for eosinophils; it interferes at every stage of their development, maturation, activation, and local recruitment. The IL-5 R consists of a specific alpha-subunit (IL-5Rα) and a common beta chain, shared with IL-3 and granulocyte- macrophage colony stimulating factor (GM-CSF) [11].