Abstract

Our understanding of the contribution of eosinophils in the pathogenesis of various diseases has grown, particularly in disorders affecting the airways, gastrointestinal tract, and skin. This has led to the development of therapies that specifically target eosinophils or cytokines responsible for their production, activation, and survival – establishing a more focused and effective treatment approach. Recent biologic agents are designed to selectively inhibit eosinophils, cells that interact with or activate them, or components of the type 2 inflammatory cascade, using monoclonal antibodies.

Currently, clinical guidelines generally reserve biologic therapies for patients who are refractory to or intolerant of corticosteroids or immunosuppressants. However, increasing evidence supporting the safety and efficacy of these agents has sparked a growing debate on whether earlier use of biologics could be beneficial. In the present article, we examine the benefits and limitations of currently approved biologics for the treatment of eosinophilic diseases involving the airways, gastrointestinal tract, and skin. Additionally, we discuss emerging biologic therapies, future research directions, and the rationale for considering early intervention with biologics to prevent irreversible tissue damage, disease progression, and organ dysfunction in selected cases.

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Carla Mastrorilli - Department of Pediatrics and Emergency. Regional Referral Center of Pediatric Pulmonology, Allergy, Immunology and Rheumatology. Pediatric Hospital Giovanni XXIII. University of Bari. Bari, Italy

Fabio Cardinale - Department of Pediatrics and Emergency. Regional Referral Center of Pediatric Pulmonology, Allergy, Immunology and Rheumatology. Pediatric Hospital Giovanni XXIII. University of Bari. Bari, Italy

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Copyright (c) 2026 Italian Journal of Pediatric Allergy and Immunology

How to Cite
Mastrorilli, C., & Cardinale, F. (2026). Biologic Therapy in Rare Eosinophil-Associated Disorders. Italian Journal of Pediatric Allergy and Immunology, 39(4). https://doi.org/10.53151/2531-3916/2025-1675
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