{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:51:24Z","timestamp":1791622284876,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005047","name":"Natural Science Foundation of Liaoning Province","doi-asserted-by":"publisher","award":["2025\u2010MS\u2010221"],"award-info":[{"award-number":["2025\u2010MS\u2010221"]}],"id":[{"id":"10.13039\/501100005047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>While eosinophils are established pathogenic drivers and therapeutic targets in asthma, their role in chronic obstructive pulmonary disease (COPD) remains conflicting. This study aimed to investigate the bidirectional associations of eosinophils with COPD and asthma, and to elucidate the potential distinct underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 302,370 UK Biobank participants, multivariable\u2010adjusted Cox proportional hazards models assessed associations between blood eosinophil counts and incident COPD, asthma, and asthma COPD overlap (ACO). Bidirectional two\u2010sample Mendelian randomization (MR) tested causality. Among 32,121 participants with available baseline Olink proteomic data, proteomic profiling characterized eosinophil\u2010associated plasma protein signatures and their associations with disease risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During approximately 13.5\u2009years of follow\u2010up, elevated blood eosinophils were associated with increased risks of COPD, asthma, and ACO. Unlike asthma, pre\u2010existing COPD did not predict subsequent eosinophil elevation. MR indicated a unidirectional effect of eosinophils on COPD but bidirectional causality for asthma. Proteomics revealed a broader protein interaction network in COPD (378 proteins) than in asthma (70 proteins). Exploratory mediation analyses, assuming an eosinophil\u2010to\u2010protein direction, estimated that the eosinophil\u2010associated proteomic signature statistically accounted for 87.8% of the association with COPD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.076) and 59.1% of the association with asthma (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among these proteins, COPD\u2010associated mediators were linked to a broad and intricately woven inflammatory network, in contrast to the more streamlined network that is mainly confined to Type 2 inflammation seen in asthma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although elevated eosinophil levels are associated with increased COPD risk, their pathogenic role\u2014embedded within a complex inflammatory network\u2014differs fundamentally from the Th2\u2010centric inflammatory pathway characteristic of asthma. This observational study suggests that eosinophilic COPD is not simply a surrogate for asthma\u2010like Type 2 inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/all.70538","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:42:32Z","timestamp":1791621752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Not Just\n                    <scp>Th<\/scp>\n                    2: Eosinophil\u2010Associated Proteomic Networks Reveal Fundamental Differences Between\n                    <scp>COPD<\/scp>\n                    and Asthma"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2954-6404","authenticated-orcid":false,"given":"Xiaojie","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Shengjing Hospital of China Medical University  Shenyang 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