Blood eosinophils and treatment response in hospitalized exacerbations of chronic obstructive pulmonary disease: A case-control study

Serafino-Agrusa, Laura; Scichilone, Nicola; Spatafora, Mario; Battaglia, Salvatore

doi:10.1016/j.pupt.2016.03.004

Cited by 38 publications

(48 citation statements)

References 28 publications

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“…It has been reported that the effects of oral corticosteroids are dependent on the blood eosinophil count during COPD exacerbations, with more likelihood of treatment failure or a longer hospital stay with lower blood eosinophil counts [11, 31, 32]. The data reported here show lower eosinophil counts during acute bacterial infections, and it could be inferred that treatment failure with oral corticosteroids in such cases is related to the presence of airway bacteria.…”

Section: Discussionsupporting

confidence: 49%

Blood and sputum eosinophils in COPD; relationship with bacterial load

et al. 2017

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BackgroundSputum and blood eosinophil counts predict corticosteroid effects in COPD patients. Bacterial infection causes increased airway neutrophilic inflammation. The relationship of eosinophil counts with airway bacterial load in COPD patients is uncertain. We tested the hypothesis that bacterial load and eosinophil counts are inversely related.MethodsCOPD patients were seen at stable state and exacerbation onset. Sputum was processed for quantitative polymerase chain reaction detection of the potentially pathogenic microorganisms (PPM) H. influenzae, M. catarrhalis and S. pneumoniae. PPM positive was defined as total load ≥1 × 104copies/ml. Sputum and whole blood were analysed for differential cell counts.ResultsAt baseline, bacterial counts were not related to blood eosinophils, but sputum eosinophil % was significantly lower in patients with PPM positive compared to PPM negative samples (medians: 0.5% vs. 1.25% respectively, p = 0.01). Patients with PPM positive samples during an exacerbation had significantly lower blood eosinophil counts at exacerbation compared to baseline (medians: 0.17 × 109/L vs. 0.23 × 109/L respectively, p = 0.008), while no blood eosinophil change was observed with PPM negative samples.ConclusionsThese findings indicate an inverse relationship between bacterial infection and eosinophil counts. Bacterial infection may influence corticosteroid responsiveness by altering the profile of neutrophilic and eosinophilic inflammation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12931-017-0570-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 49%

Blood and sputum eosinophils in COPD; relationship with bacterial load

et al. 2017

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“…Bafadhel et al also observed that, among patients admitted for COPD exacerbation, those with blood eosinophils ≥2% or ≥200 cells/μL had a shorter length of hospital stay . Similar results were found in a study of 137 patients with COPD hospitalized in Italy . Studying the effect of asthma‐like features on the clinical course of COPD in Japan, Suzuki et al also found that blood eosinophils <300 cells/μL was associated with a significantly faster decline in post‐bronchodilator FEV1 .…”

Section: Discussionmentioning

confidence: 55%

“…34 Similar results were found in a study of 137 patients with COPD hospitalized in Italy. 17 Studying the effect of asthma-like features on the clinical course of COPD in Japan, Suzuki et al also found that blood eosinophils <300 cells/lL was associated with a significantly faster decline in post-bronchodilator FEV1. 35 With regard to pulmonary infections, it has been suggested that in COPD, a low eosinophil count correlated with more frequent bacterial infections and a higher bacterial load of Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae.…”

Section: Discussionmentioning

confidence: 99%

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Blood biomarkers as predictors of long‐term mortality in COPD

Mendy

Forno

Niyonsenga

et al. 2018

Clinical Respiratory J

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“…Thus, we excluded patients who possibly had taken steroids before enrollment. Third, although several comparative studies investigating eosinophilic COPD have been published, all have been retrospective analyses 18,20,31,32 and included patients taking steroids before enrollment. Fourth, we did sensitivity analysis using alternativity cutoffs at 2%, 100/µL, and 300/µL to avoid bias.…”

Section: 994mentioning

confidence: 99%

<p>Peripheral Blood Eosinophil as a Biomarker in Outcomes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease</p>

Wu¹,

Zhuo²,

Cheng³

2019

COPD

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Mounting evidence suggests that eosinophil levels correlate with the effects of therapy and phenotype for chronic obstructive pulmonary disease (COPD). This study aimed to clarify the relationship between eosinophil levels and clinical outcomes in patients with acute exacerbation of COPD (AECOPD). Methods: A prospective, multicenter, observational cohort study was performed in three teaching hospitals. Patients were grouped by quartile percentage (0, 0.7, 2.55) and absolute blood eosinophils count (0, 0.05×10 9 /L, 0.17×10 9 /L) and divided into four numbered groups ranked from low to high. Results: The study included 493 AECOPD patients. In the percentile-ranked groups, patients in Group 1 experienced significantly longer hospital stays, higher rates of both noninvasive mechanical ventilation (NIMV), and heart failure than those in Group 4 (12 days vs 10 days, p = 0.005; 29.5% vs 23.6%, p = 0.007; 48.4% vs 28.5%, p = 0.001). Group 1 also had higher frequencies of respiratory failure and pulmonary heart disease compared to Groups 3 and 4 (54.8% vs 34.8%, p = 0.002; 54.8% vs 35%, p = 0.003). In the absolute count-ranked groups, patients in Group 1 had significantly higher rates of NIMV than those in Group 3 (41.1% vs 21.7%, p = 0.001), had higher rates of heart failure, respiratory failure, and pulmonary heart disease than those in Group 3 and 4 (48.1% vs 30.2%, p = 0.003; 48.1% vs 30.4%, p = 0.005; 50.8% vs 32.2%, p = 0.004; 50.8% vs 34.1%, p = 0.008; 51.9% vs 34.1%, p = 0.004; 51.9% vs 33%, p = 0.003). There were outcome differences among the admitting hospital of stays in the absolute count groups (p = 0.002), but the differences were not significant in a pairwise comparison. The proportion of ICU admissions and mortality was different in two cohorts with no difference in a pairwise comparison. Conclusion: Patients with lower eosinophil counts experienced poorer clinical outcomes. Eosinophil levels may be a helpful marker to predict outcomes in AECOPD.

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Blood eosinophils and treatment response in hospitalized exacerbations of chronic obstructive pulmonary disease: A case-control study

Cited by 38 publications

References 28 publications

Blood and sputum eosinophils in COPD; relationship with bacterial load

Blood and sputum eosinophils in COPD; relationship with bacterial load

Blood biomarkers as predictors of long‐term mortality in COPD

<p>Peripheral Blood Eosinophil as a Biomarker in Outcomes of Acute Exacerbation of Chronic Obstructive Pulmonary Disease</p>

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