This discordance between blood and sputum eosinophilia in patients treated with chronic systemic steroids and anti-IL5 biologics is likely due to the suppression of systemic but not local airway eosinophilopoiesis (36), and, critically, suppression of local airway eosinophilopoiesis appears to be most important in determining the effectiveness of IL5 inhibition (37). Here, IL5 is linked to Increased total eosinophil count.