Immunological and epithelial barrier dysfunction in EGPA: the possible role of new biomarkers
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis with heterogeneous clinical manifestations. Identifying reliable biomarkers is crucial to predicting disease evolution and guiding therapy. We analyzed clinical, biological, and functional data from 33 patients with EGPA in the vasculitic phase. Blood eosinophil count (BEC), eosinophilic cationic protein (ECP), antineutrophil cytoplasmic antibodies (ANCAs), specific IgE to staphylococcal enterotoxins (SE-IgE), and serum free light chains (FLCs) were evaluated. Severe eosinophilic asthma (SEA) and chronic rhinosinusitis with nasal polyps (CRSwNPs) were present in 100% and 88.5% of patients, respectively. Median BEC was 1950 cells/mm3, with elevated ECP (60.0 µg/L). SE-IgE was detected in 54.2% of patients. A significant negative correlation emerged between λ FLCs and oral corticosteroid (OCS) dose (r = –0.58, p = 0.009). Forced expiratory volume in 1 second (FEV1) was significantly lower in C-ANCA+ patients (p = 0.006). ECP and SE-IgE may serve as markers of eosinophilic activity and epithelial barrier damage in EGPA. λ FLCs might be a useful indicator of OCS exposure and treatment response. These biomarkers could support the evaluation of disease evolution and treatment response.
Authors
- Umberto Basile (ORCID: https://orcid.org/0000-0002-8328-2570)
- Gabriele Ciasca (ORCID: https://orcid.org/0000-0002-3694-8229)
- Mario Rigante (ORCID: https://orcid.org/0000-0002-6111-0786)
- Chiara Laface
- Vincenzo Patella (ORCID: https://orcid.org/0000-0001-5640-6446)
- E. Greco (ORCID: https://orcid.org/0000-0001-6062-3056)
- Paola Anselmi
- Aikaterini Detoraki (ORCID: https://orcid.org/0000-0002-3692-1384)
- Benedetta Niccolini (ORCID: https://orcid.org/0000-0002-3233-1897)
- David Longhino (ORCID: https://orcid.org/0000-0001-9039-838X)
- Gabriele Lucca
- Eleonora di Carluccio (ORCID: https://orcid.org/0000-0002-5618-1141)
- Antonio Gasbarrini (ORCID: https://orcid.org/0000-0003-4863-6924)
- Ilaria Baglivo (ORCID: https://orcid.org/0000-0003-4041-5182)
- Maria Antonietta Zavarella
- Laura Bruno
- Fabio Romano Selvi
- E De Corso
- Giovanni Battista Capoccetta
- Cristiano Caruso (ORCID: https://orcid.org/0000-0001-7631-029X)
- Stefania Colantuono (ORCID: https://orcid.org/0000-0002-8207-9837)
- Stefano Del Giacco (ORCID: https://orcid.org/0000-0002-4517-1749)
- Benedetta Bondi (ORCID: https://orcid.org/0009-0005-5754-4636)
Institutions
- Università Cattolica del Sacro Cuore (IT)
- University of Rome Tor Vergata (IT)
- University of Cagliari (IT)
- AO Foundation (CH)
- Villa Maria Hospital (UG)
- Agostino Gemelli University Polyclinic (IT)
- University Hospital Foundation (CA)
- Federico II University Hospital (IT)
- Nederlands Astmacentrum Davos (CH)
- Ospedale Santa Maria Goretti (IT)
- Ospedale Policlinico San Martino (IT)
- Hochgebirgsklinik Davos (CH)
Publication Details
- Journal
- Exploration of Asthma & Allergy
- Published
- 2026-05-27
- DOI
- https://doi.org/10.37349/eaa.2026.1009127
- Primary Topic
- Sinusitis and nasal conditions
- Type
- article
- Field-Weighted Citation Impact
- 0.00