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Eosinophilia and eosinophil activation are recurrent features in various reactive states and certain hematologic malignancies. In patients with hypereosinophilia (HE), HE‐induced organ damage is often encountered and may lead to the diagnosis of a hypereosinophilic syndrome (HES). A number of known mechanisms and etiologies contribute to the development of HE and HES. Based on these etiologies and the origin of eosinophils, HE and HES are divided into primary forms where eosinophils are clonal cells, reactive forms where an underlying reactive or neoplastic condition is detected and eosinophils are considered to be "non‐clonal" cells, and idiopathic HE and HES in which neither a clonal nor a reactive underlying pathology is detected. Since 2012, this classification and the related criteria have been widely accepted and regarded as standard. However, during the past few years, new developments in the field and an increasing number of markers and targets have created a need to update these criteria and the classification of HE and HES. To address this challenge, a Working Conference on eosinophil disorders was organized in 2021. In this conference, a panel of experts representing the relevant fields, including allergy, dermatology, hematology, immunology, laboratory medicine, and pathology, met and discussed new markers and concepts as well as refinements in definitions, criteria and classifications of HE and HES. The outcomes of this conference are presented in this article and should assist in the diagnosis and management of patients with HE and HES in daily practice and in the preparation and conduct of clinical trials. [ABSTRACT FROM AUTHOR]

Background: Dysphagia is the main symptom of adult eosinophilic esophagitis (EoE). We describe a novel syndrome, referred to as "food‐induced immediate response of the esophagus" (FIRE), observed in EoE patients. Methods: Food‐induced immediate response of the esophagus is an unpleasant/painful sensation, unrelated to dysphagia, occurring immediately after esophageal contact with specific foods. Eosinophilic esophagitis experts were surveyed to estimate the prevalence of FIRE, characterize symptoms, and identify food triggers. We also surveyed a large group of EoE patients enrolled in the Swiss EoE Cohort Study for FIRE. Results: Response rates were 82% (47/57) for the expert and 65% (239/368) for the patient survey, respectively. Almost, 90% of EoE experts had observed the FIRE symptom complex in their patients. Forty percent of EoE patients reported experiencing FIRE, more commonly in patients who developed EoE symptoms at a younger age (mean age of 46.4 years vs 54.1 years without FIRE; P <.01) and in those with high allergic comorbidity. Food‐induced immediate response of the esophagus symptoms included narrowing, burning, choking, and pressure in the esophagus appearing within 5 minutes of ingesting a provoking food that lasted less than 2 hours. Symptom severity rated a median 7 points on a visual analogue scale from 1 to 10. Fresh fruits/vegetables and wine were the most frequent triggers. Endoscopic food removal was significantly more commonly reported in male patients with vs without FIRE (44.3% vs 27.6%; P =.03). Conclusions: Food‐induced immediate response of the esophagus is a novel syndrome frequently reported in EoE patients, characterized by an intense, unpleasant/painful sensation occurring rapidly and reproducibly in 40% of surveyed EoE patients after esophageal contact with specific foods. [ABSTRACT FROM AUTHOR]

Enrolled patients presented with either a newly diagnosed disease or a relapse of BP.[1] The primary endpoint was the cumulative rate of relapse-free patients after initiating therapy. Despite the fact that mepolizumab did not significantly affect the clinical outcome, we found significantly lower peripheral blood eosinophil levels in patients treated with mepolizumab compared to patients receiving placebo (Table). (b) Since we could not estimate the effect of mepolizumab in these elderly patients in advance, for ethical reasons, we chose an add-on therapy, that is, mepolizumab or placebo were administered in addition to the standardized therapy with OCS. Even after therapy, eosinophils were detectable in the skin both in patients with and without relapse of BP. [Extracted from the article]

Remarkably, our results are comparable with those of clinical and real-life studies, although exclusively patients with severe AD were eligible to get dupilumab therapy. SP S5-S11,S14,S15 sp Already one month after initiating dupilumab therapy, 60% reported that AD did not or minimally affected their quality of life (Figure 1). Keywords: atopic dermatitis; dupilumab; epidermal barrier; interleukin-13; type 2 inflammation EN atopic dermatitis dupilumab epidermal barrier interleukin-13 type 2 inflammation 1268 1270 3 04/14/21 20210401 NES 210401 The pathogenesis of atopic dermatitis (AD), a common chronic inflammatory skin disease, is based on a genetic predisposition that determines both skin barrier function and type 2 immune reaction.1,2 SP ,S1-S4 sp Type 2 cytokines may further impair the epidermal barrier and trigger AD inflammation.1 Therapy with dupilumab that inhibits the action of interleukin (IL)-4 and IL-13 by blocking the shared receptor results in a rapid improvement of symptoms, clinical signs, and quality of life in AD patients.3 SP ,S5-S11 sp Transcriptome analyses of skin samples suggest that it affects mRNA expression of genes related to type 2 inflammation, T helper (Th)17/Th22 pathways, dendritic cells, epidermal barrier, and lipid metabolism.4,5 SP ,S12-S13 sp This study aimed at assessing the efficacy and safety of dupilumab therapy in patients with AD referred to a tertiary center and at investigating the effect of dupilumab on both inflammation and epidermal barrier by applying immunofluorescence techniques. [Extracted from the article]

The 4th Davos Declaration was developed during the Global Allergy Forum in Davos which aimed to elevate the care of patients with atopic dermatitis (AD) by uniting experts and stakeholders. The forum addressed the high prevalence of AD, with a strategic focus on advancing research, treatment, and management to meet the evolving challenges in the field. This multidisciplinary forum brought together top leaders from research, clinical practice, policy, and patient advocacy to discuss the critical aspects of AD, including neuroimmunology, environmental factors, comorbidities, and breakthroughs in prevention, diagnosis, and treatment. The discussions were geared towards fostering a collaborative approach to integrate these advancements into practical, patient-centric care. The forum underlined the mounting burden of AD, attributing it to significant environmental and lifestyle changes. It acknowledged the progress in understanding AD and in developing targeted therapies but recognized a gap in translating these innovations into clinical practice. Emphasis was placed on the need for enhanced awareness, education, and stakeholder engagement to address this gap effectively and to consider environmental and lifestyle factors in a comprehensive disease management strategy. The 4th Davos Declaration marks a significant milestone in the journey to improve care for people with AD. By promoting a holistic approach that combines research, education, and clinical application, the Forum sets a roadmap for stakeholders to collaborate to improve patient outcomes in AD, reflecting a commitment to adapt and respond to the dynamic challenges of AD in a changing world., (© 2024 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)