Understanding the relationship between eosinophils and chronic obstructive pulmonary disease. A new dawn?

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is a leading cause of global morbidity and mortality. It is a complex and heterogeneous condition defined by the presence of an incompletely reversible airflow obstruction.

AREA COVERED: Airway inflammation and remodeling are central to the pathogenesis of this airflow limitation, and eosinophilic or type 2 inflammation has emerged as a measurable and treatable therapeutic target in those patients in whom it is identified. This review addresses the role of type 2 inflammation in COPD pathogenesis as well as current and future therapeutic options.

EXPERT OPINION: The last 15 years has seen the emergence of a precision medicine, type-2 biomarker directed approach to the use of inhaled corticosteroids in COPD, resulting in better targeting of treatment and an increased benefit/risk ratio. We have also seen the approval of first biological therapy against type 2 inflammation in COPD. There is increasing interest in biomarker directed early intervention to prevent progression or even the development of COPD.