Medical Journal Reviews

The International Eosinophil Society (IES) selects articles on a monthly basis for their importance to scientists and clinicians interested in the eosinophil. We welcome Medical Journal Review submissions from IES Members for consideration. Your review should be clear, compelling, and appeal to our international membership.

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April 2026

Eosinophils Under Stress: A Sympathetic Circuit That Fuels Dermatitis

Article: A sympathetic-eosinophil axis orchestrates psychological stress to exacerbate skin inflammation 
Tian J, Cao Y, Li Y, et al.
Science. 2026

Reviewed by Delaney Ding, University of Florida, Florida, United States

Stress is a well-known trigger for atopic dermatitis flare-ups, but the pathway linking the brain to eosinophil-rich skin inflammation has remained unclear. Tian and colleagues address that question using patient data, mouse dermatitis models, transcriptomics, neuronal tracing, optogenetics, and cell-specific genetic manipulation. 

The study first showed that in patients with atopic dermatitis, higher perceived stress was associated with worse disease severity and higher blood and skin eosinophil levels. In mice, repeated high-platform stress worsened dermatitis, increasing transepidermal water loss, scratching, dermal thickening, and eosinophil accumulation. Eosinophil depletion blunted this stress-driven worsening, showing that eosinophils were required. The authors then identified a distinct subset of prodynorphin-positive (Pdyn+) sympathetic 1 neurons that innervate hairy skin. Functional studies showed that Pdyn+ sympathetic neurons, but not neuropeptide Y-positive (Npy+) sympathetic neurons, were necessary and sufficient to drive stress aggravated dermatitis and eosinophilia. Mechanistically, these neurons recruited eosinophils through CCL11-CCR3 signaling and activated them through eosinophil Adrb2, promoting local inflammatory responses.

This is a significant paper because it moves beyond correlation and builds a causal neuroimmune circuit with several complementary approaches. The human cohort gives the work clinical relevance, while the mouse experiments provide mechanistic depth. Another strength is that the authors distinguish between sympathetic neuron subsets rather than treating the sympathetic nervous system as a single uniform stress pathway.

The main limitations are translational. The human data are retrospective and associative, and most of the mechanistic work is in mice. It also remains unclear whether the same circuit operates in human disease, whether it is specific to atopic dermatitis, and how it interacts with established type 2 inflammatory pathways already targeted in clinic.

Overall, this study pushes eosinophil biology into neuroimmunology. It argues that eosinophils are active participants in a defined stress-responsive circuit, not just downstream markers of inflamed skin. The next step is to test whether disrupting this neuro-eosinophil axis can reduce stress-related disease flares.

TemplateDelaney Ding is an MD-PhD trainee in Epidemiology and Data Science at the University of Florida with research interests in dermatologic disease, immune-mediated disease, epidemiology, informatics, data science, health equity, and translational research. His work focuses on using clinical and population-level data to understand disease risks, mechanisms, and outcomes.

 

 


Past Reviews

February 2026

Eosinophils in the Real World: Spotting Hidden Hypereosinophilic Syndrome with Prediction Modeling
Reviewed by Stella Oyewole, University of Cincinnati College of Medicine, Ohio, United States

August 2025

Eosinophils and EGPA: How Far Can Mepolizumab Go?
Reviewed by Palma Carlucci, University of Bari Aldo Moro, Bari, Italy

March 2025

Eosinophils at the Table: Is a Milk-Only Diet Effective for Pediatric Eosinophilic Esophagitis?
Reviewed by Nicholas Genovese, Jefferson Einstein Philadelphia Hospital, Pennsylvania, United States

January 2025

Eosinophils in Check: The Promise of Benralizumab in EGPA Management
Reviewed by Federico Spataro & Antonio Giovanni Solimando, University of Bari, Italy

Eosinophils Under Fire: Benralizumab for Eosinophilic Asthma and COPD Exacerbations
Reviewed by Carlos Andrés Celis-Preciado, University of Sherbrooke, Canada

October 2024

Biannual Depemokimab for Severe Eosinophilic Asthma
Reviewed by Santi Nolasco, University of Catania, Italy

September 2024

Nutrient-derived signals regulate eosinophil adaptation to the small intestine
Reviewed by Clotilde Lacroix, University of Bonn, Germany

Single-cell proteomics and transcriptomics capture eosinophil development and identify the role of IL-5 in their lineage transit amplification
Reviewed by Alexandre Ecrement, University of Franche-Comté, Franche-Comté, France

August 2024

Utility of eosinophil peroxidase as a biomarker of eosinophilic inflammation in asthma
Reviewed by Nicholas Genovese, Jefferson Einstein Philadelphia Hospital, Pennsylvania, United States

July 2024

Eosinophil Depletion with Benralizumab for Eosinophilic Esophagitis
Reviewed by Mario Ynga-Durand, MD, PhD, Cincinnati Children's Hospital Medical Center, Ohio, United States

June 2024

Subsets of sputum eosinophils in asthma exacerbations
Reviewed by Jakub Novosad, MD, PhD, Institute of Clinical Immunology and Allergy, University Hospital, Hradec Kralove, Czech Republic

April 2024

Eosinophils potentiate anti-bacterial immunity
Reviewed by Roopa Hebbandi Nanjundappa, MSc, PhD, Dalhousie University, Halifax, Canada

March 2024

Nourishing insights: diet-driven adaptation of eosinophils
Reviewed by Krishan Chhiba, MD, PhD, Northwestern University, Chicago, United States

February 2024

Eosinophils identified as a major contributor to bone homeostasis via eosinophil peroxidase activity
Reviewed by Nana-Fatima Haruna, PhD Candidate, Northwestern University, Chicago, United States

January 2024

Transcriptomic profiling of the acute mucosal response to local food injections in adults with eosinophilic esophagitis
Reviewed by Eva Gruden, Pharmacist, Medical University of Graz, Austria

December 2023

Bordetella spp. block eosinophil recruitment to suppress the generation of early mucosal protection
Reviewed by Rachael FitzPatrick, PhD Candidate, Reynolds Laboratory at the University of Victoria, Canada

October 2023

Neuromedin U programs eosinophils to promote mucosal immunity of the small intestine
Reviewed by Beth Jacobson, PhD with input from Marc Rothenberg, MD, PhD

Chronic HDM exposure shows time-of-day and sex-based differences in inflammatory response associated with lung circadian clock disruption
Reviewed by Julia Teppan, MSc.Ph.D.Student

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