Sylvia Hartl

Full Citation: Hartl, S., Breyer, M. K., Burghuber, O. C., et al. Blood eosinophil count in the general population: typical values and potential confounders. European Respiratory Journal, 2020, 55(5), 1901874.

Epidemiological studies are crucial for translational and basic clinical studies.

Assoc. Prof. Sylvia Hartl, MD, PhD, from the Ludwig Boltzmann Institute for Lung Health of the Clinic Penzing, Vienna, Austria, is very happy to have been selected as one of this year's IMA finalists, as this means that the work of her whole team has been acknowledged, which is particularly important for epidemiological studies like theirs because when compared to interventional ones, it is much harder to get funded, regardless of the importance and the implications epidemiological studies have both for translational as well as basic clinical research.

In her current research, her team have looked into blood eosinophils in a general population sample.

We have researched blood eosinophils because they are inflammatory cells in our blood that are heavily involved in the development of allergies and progression of certain chronic diseases, such as asthma or chronic obstructive pulmonary disease (COPD). In the study we included the population between the ages of 6 and 80, because we were looking for the risk factors of various lung diseases. It is not common knowledge that our lungs grow until the age of 20 and many people fail to realize how important it is to have healthy lungs. Our childhood and early adulthood are very important periods in our growth, and many of us do not show any signs of a disease at that age yet, but there might be many environmental risk factors when we are growing up. Such risks are the exposure to passive smoking in childhood, active smoking in adolescence, lack of physical activity, all of which might lead to severe lung diseases in adult life. Moreover, lung diseases can play a crucial role in the development of other diseases.

Blood eosinophils are now used as biomarkers which could predict the reaction to specific medical therapies, for instance to determine how a COPD patient will respond to corticosteroids. On the other hand, blood eosinophils are a biomarker for specific therapies because there is a development of anti-eosinophilic therapies and we need to look for the cut-off point to set an indication. The role of blood eosinophils in a healthy regulation of the immune system is not fully understood yet. This is why we were looking for blood eosinophils in a healthy population. We have found very high blood eosinophil counts in young children and adolescents (which is a natural prevalence because they need them to set up their immune system properly), but in adults we found that the blood eosinophils reduce in number and are much lower than we had formerly expected. Looking for all these cut-offs, it is important to know what the normal levels in a population are, so we can define high, normal and low levels. I am sure that through these findings we can influence the setting of the levels for anti-eosinophil medical therapy in the future,

is convinced Prof. Hartl.

As a respiratory physician, Prof. Hartl has been deeply involved in the treatment of Covid patients, too, and she admits to health care professionals having been quite unprepared for the epidemic of such a large scale. After several months of living with the virus, she acknowledges the fact that people are scared and also full of conspiracy theories they read on the internet, but she believes that most of us are born to survive. Plus, in Europe and other high-income countries around the world, we are very lucky to have extremely good resources which will help us get out of the crisis relatively unharmed. She also strongly believes that challenges are urgently needed for the development of the human race.

You never know what you are capable of doing unless you try. Our society can and will find the way out of this crisis for sure. It might not be moving along the well-known paths and as soon as expected, but we have the potential to find a solution. And then we will also realize what a small challenge this was. So many people are dealing with much bigger challenges around the world, like fighting famine, dying from treatable diseases, being refugees, etc. Now, we have to admit that a lock-down for a couple of weeks to save our lives is completely feasible and is not the worst scenario that can happen!