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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February 2026
Eosinophils in the Real World: Spotting Hidden Hypereosinophilic Syndrome with Prediction Modeling
Article: Prediction model to identify patients with hypereosinophilic syndrome using real-world data
Khoury P, Chung Y, Carsten D, et al.
J Allergy Clin Immunol Glob. 2025
Reviewed by Stella Oyewole, University of Cincinnati College of Medicine, Ohio, United States
Hypereosinophilic syndrome (HES) is a rare and heterogeneous disorder defined by persistent peripheral eosinophilia (≥1,500/µL) accompanied by tissue or organ damage. The diagnosis of HES can be challenging owing to variable clinical presentations and overlap with other eosinophilic disorders, thus may be underrecognized. Machine learning predictive tools may offer an approach to better understand HES prevalence. Read more
In this study, investigators developed a machine learning–based prediction model using an open claims database including patients (with/without HES ICD-10 code) who had ≥2 blood eosinophil counts >1,000 cells/μL. This lower threshold was chosen to capture a broader population, including patients with treatment-suppressed counts. Selected predictors included demographics, disease manifestations, comorbidities, treatments, and healthcare utilization.
Selected variables were incorporated into a statistical model to estimate predicted probabilities of HES risk across thresholds from 0.1–0.9. Key predictors included having a bone marrow biopsy, blood eosinophil count >3,000/µL, and history of asthma. Model performance was evaluated using Receiver Operating Characteristics Area under the curve (ROC AUC) and Precision-Recall AUC (PR AUC) to assess overall discrimination and precision, both demonstrated strong results (ROC AUC = 0.82; PR AUC = 0.83). At a 0.7 probability threshold, 6,233 additional patients with predicted HES were identified and exhibited characteristics similar to diagnosed cases. The estimated model-derived prevalence of total HES (diagnosed plus predicted) was 5.65% among individuals with elevated eosinophil counts, suggesting underdiagnosis.
Strengths of this study include a large real-world dataset and a robust predictive approach. Limitations include potential misclassification of HES in secondary datasets and limited generalizability to patients with lower blood eosinophil counts. Given that HES is often diagnosed late, this model may enable earlier identification of HES patients, prompting timely referral & intervention, although it is not a stand-alone diagnostic tool and requires clinical interpretation and further validation. Rather than distinguishing primary (clonal/idiopathic) HES from secondary (reactive) eosinophilia, the model is designed to flag patients whose overall patter of findings resemble those with a recorded HES diagnosis. In addition to external validation of model and extension to identification of tissue-based HES, future studies could be focused on developing machine-learning based tools to facilitate earlier diagnosis of HES in the population. Overall, these findings suggest that machine learning-based prediction may improve HES detection and reveal an underrecognized disease burden.
Stella Oyewole is a PhD candidate at the University of Cincinnati College of Medicine. She earned her Doctor of Dental Surgery (DDS) degree from Obafemi Awolowo University in Nigeria. Her doctoral research focuses on evaluating cell- and tissue-informed circulating biomarkers to assess tissue-specific disease activity in eosinophil-associated diseases (EAD). Under the mentorship of Dr. Nives Zimmermann, her work aims to support earlier and more precise diagnosis of these disorders and improve understanding of their underlying biology.
Past Reviews
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