Eosinophils in allergic rhinitis harbor a substantial yet underrecognized immunoregulatory capacity that encompasses IL-10-mediated Treg crosstalk, TGF-b-driven immune tolerance, lipid mediator class-

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

• The emerging roles of eosinophils in immune regulation in health and disease (2026) · doi

  The author(s) declared that financial support was not received for this work and/or its publication. This review confirms that eosinophils occupy a central position in immune networks and, as such, being implicated in an increas- ingly diverse array of health and disease contexts. While further research on the roles of eosinophils in immune regulation is it appears that IL-4, IL-5 and IFN-g necessary and ongoing, pathways may be especially important in eosinophil-mediated immune regulation of diseases, including — but not limited to — homeostasis, cancer, respiratory, reproductive, vascular, gastroin- testinal, muscular and immune diseases. Although their roles are crucial, it appears that the microenvi- ronment of eosinophils is itself a key determinant of eosinophils’ immunological roles, whether pro- or anti-inflammatory, beneficial or detrimental, prognostically good or poor. Understanding the factors at work in the healthy eosinophilic microenvironment — and those that skew it in disease — is vital in order to devise effective treatments for eosinophil-associated diseases. It is due to their central role in immunity that treatment of eosinophil-based disor- ders must be targeted. For example, although IL-5 blocking mono- clonal antibody is successfully used in the treatment of eosinophilic asthma, this strategy also works to greatly reduce airway tissue, periphery and bone-marrow eosinophils. This approach, through down-regulation of eosinophil numbers and functions, places the organism at loss of the numerously beneficial, pro-inflammatory and anti-tumorigenic roles that eosinophils also have to offer, in the regulation of diseases such as cancer, tissue repair and respiratory diseases, in which eosinophilia is associated with a good prognosis. Ideally, taking advantage of the pioneering of asthma IL-5 blocking antibody, future treatment strategies should be rather more targeted to diseases-specific mediators in order to prevent indiscriminate eosinophil ablation. This ambitious aim, while simply stated, may Conflict of interest The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

  Keywords: eosinophils diseases eosinophil immune roles regulation treatment author declared nancial central disease appears cancer respiratory
• Eosinophils as immunoregulatory players in allergic rhinitis: beyond cytotoxicity (2026) · doi

  Eosinophils in allergic rhinitis harbor a substantial yet underrecognized immunoregulatory capacity that encompasses IL-10-mediated Treg crosstalk, TGF-b-driven immune tolerance, lipid mediator class-switching from CysLTs to SPMs, and func- tional heterogeneity between tissue-resident and inflammatory subsets.

  Keywords: eosinophils allergic rhinitis harbor substantial underrecognized immunoregulatory capacity encompasses mediated treg crosstalk driven immune tolerance
• Pro-inflammatory and counter-regulatory modulators of interleukin-5–driven eosinophil programs: a framework for precision medicine in eosinophilic diseases (2026) · doi

  IL-5 contributes to the amplification of type 2 inflammation through its diverse actions on eosinophils. Although SEA, CRSwNP, EGPA, HES, and other eosinophilic diseases share a type 2-inflamed foundation, the target organs and immune envi- ronments differ by condition, shaped by factors such as allergen exposure, microbial responses, and coexisting autoimmune inflam- mation. Within these contexts, IL-5-conditioned eosinophil re- sponses may be further enhanced by pro-inflammatory cues, including IL-4/IL-13, epithelial alarmins such as IL-33, pattern- recognition receptor signaling, and IFN-g—whereas type I interfer- ons and retinoic acid may counter-regulate these programs. Even in this heterogeneous landscape, targeting IL-5 as a key bottleneck in eosinophil activation is a rational and effective strategy to control disease activity in many patients with these eosinophilic disorders. Advancing precision medicine toward sustained remission will require improved tools to quantify IL-5-dependent activity using accessible biomarkers such as blood and sputum eosinophil counts, eosinophil granule proteins, and markers of ETosis such as galectin- 10. The development and prospective validation of such biomarker and profiling strategies will be essential for optimizing patient stratification, therapy selection, and treatment sequencing toward long-term disease control.

  Keywords: eosinophil type cation eosinophilic control disease activity toward contributes ampli ammation diverse actions eosinophils crswnp