Eosinophilic Lung Diseases: Approaches to Differential Diagnosis and Treatment (Review)

An analysis of data from world experience and professional publications on modern approaches to the differential diagnosis of eosinophilic lung diseases and treatment of relevant categories of patients was carried out.These diseases, in the pathogenesis of which eosinophils play a key role, can have various clinical manifestations that require careful differential diagnosis to establish the correct diagnosis and choose the correct treatment tactics. Eosinophilic diseases of the respiratory tract include such common diseases as bronchial asthma and chronic rhinosinusitis with nasal polyps, as well as diseases affecting other organs and systems— primary eosinophilic disorders of the gastrointestinal tract and rare diseases, such as eosinophilic granulomatosis with polyangiitis and hypereosinophilic syndrome. On the basis of literature data, the characteristics of type 2 inflammation, approaches to diagnosis and the latest methods of treatment of pathologies associated with hypereosinophilia were analyzed, with an emphasis on lung diseases.It has been established that a multidisciplinary approach and careful differential diagnosis should be used to diagnose eosinophilic diseases. Allergens are not the only antigens capable of inducing dysregulated Th2 inflammation, and IgE-mediated allergic sensitization may be present without clinical significance or even be absent in the aforementioned diseases. A deep understanding of the pathogenesis of eosinophilic diseases has led to the rapid development of targeted therapy for patients. Today, it is the newest biological drugs that have a significant impact on the choice of treatment strategy for the relevant categories of patients.