Nasal lavage is better than blood count in predicting sputum eosinophilia

Amorim, Maria Marta; Fernandes, Patricia Bueno Lima; Caetano, Lilian Ballini; Dracoulakis, Samir; Santoro, Ilka Lopes; Fernandes, A. L. G.

doi:10.1111/cea.12512

Cited by 4 publications

(3 citation statements)

References 11 publications

(17 reference statements)

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“…Our data demonstrated that blood eosinophils and their ratios (ELR and ENR) were elevated in patients with sputum eosinophilia compared with those without. Absolute blood eosinophil counts correlated reasonably well with both the absolute sputum counts and percentage sputum eosinophils, which is in agreement with the findings of Wagener et al, 18 Zhang et al, 16 and Fowler et al 17 in asthma, but not with those of Hastie et al 34 and Amorim et al 40 In accordance with a previous finding in asthma, 16 in our study, both blood ENR and ELR also correlated with percentage sputum eosinophils and were predictive of eosinophilic COPD with AUCs of 0.81 and 0.74, respectively. Recently, Khatry et al 41 have suggested that ratios of blood cell types, such as ELR and ENR, may minimize variations associated with measurement, sample processing, and therapies and yield a more accurate diagnostic performance over actual blood cell counts.…”

Section: Discussionsupporting

confidence: 89%

Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD

Negewo¹,

McDonald²,

Baines³

et al. 2016

COPD

143

129

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IntroductionSputum eosinophilia occurs in approximately one-third of stable chronic obstructive pulmonary disease (COPD) patients and can predict exacerbation risk and response to corticosteroid treatments. Sputum induction, however, requires expertise, may not always be successful, and does not provide point-of-care results. Easily applicable diagnostic markers that can predict sputum eosinophilia in stable COPD patients have the potential to progress COPD management. This study investigated the correlation and predictive relationship between peripheral blood and sputum eosinophils. It also examined the repeatability of blood eosinophil counts.MethodsStable COPD patients (n=141) were classified as eosinophilic or noneosinophilic based on their sputum cell counts (≥3%), and a cross-sectional analysis was conducted comparing their demographics, clinical characteristics, and blood cell counts. Receiver operating characteristic curve analysis was used to assess the predictive ability of blood eosinophils for sputum eosinophilia. Intraclass correlation coefficient was used to examine the repeatability of blood eosinophil counts.ResultsBlood eosinophil counts were significantly higher in patients with sputum eosinophilia (n=45) compared to those without (0.3×109/L vs 0.15×109/L; P<0.0001). Blood eosinophils correlated with both the percentage (ρ=0.535; P<0.0001) and number of sputum eosinophils (ρ=0.473; P<0.0001). Absolute blood eosinophil count was predictive of sputum eosinophilia (area under the curve =0.76, 95% confidence interval [CI] =0.67–0.84; P<0.0001). At a threshold of ≥0.3×109/L (specificity =76%, sensitivity =60%, and positive likelihood ratio =2.5), peripheral blood eosinophil counts enabled identification of the presence or absence of sputum eosinophilia in 71% of the cases. A threshold of ≥0.4×109/L had similar classifying ability but better specificity (91.7%) and higher positive likelihood ratio (3.7). In contrast, ≥0.2×109/L offered a better sensitivity (91.1%) for ruling out sputum eosinophilia. There was a good agreement between two measurements of blood eosinophil count over a median of 28 days (intraclass correlation coefficient =0.8; 95% CI =0.66–0.88; P<0.0001).ConclusionPeripheral blood eosinophil counts can help identify the presence or absence of sputum eosinophilia in stable COPD patients with a reasonable degree of accuracy.

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Section: Discussionsupporting

confidence: 89%

Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD

Negewo¹,

McDonald²,

Baines³

et al. 2016

COPD

143

129

View full text Add to dashboard Cite

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“…Besides, De Corso et al (32) suggested that patients of nonallergic rhinitis with nasal hypereosinophilia were at higher risk of development of nasal polyps and therefore in need of intensive treatment. With the concept of "the same airway, the same disease", nasal eosinophilia was also considered an alternative marker for eosinophilic asthma and better than blood eosinophil count in predicting sputum eosinophilia (33)(34)(35) . All those studies suggested that nasal fluid cytology and cytokine levels could be used as a quick, fast and non-invasive method to help in detecting and managing airway inflammation.…”

Section: Discussionmentioning

confidence: 99%

Nasal fluid cytology and cytokine profiles of eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps

Zhu¹,

Wang²,

Zhang³

et al. 2020

Rhin

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Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease with different clinical characteristics and different treatment responsiveness. The aims of this study were to compare the nasal fluid cytology and cytokines between eosinophilic CRSwNP (eCRSwNP) and non-eosinophilic CRSwNP (neCRSwNP) and establish a new multivariate model to predict eCRSwNP before surgery to improve personalized treatment for CRSwNP patients.Methods: Eighty-six consecutive patients with CRSwNP and sixteen healthy controls were recruited in this study. Nasal fluid (NF) was collected from all subjects and nasal polyp tissue was collected during the surgery. The differential cell counts and concentrations of IL-6, IL-8, TNF-α and IL-10 in NF were measured. Univariate and multivariate logistic regression were used to identify predictors for eCRSwNP.Results: There were more inflammatory cells in NF of CRSwNP than controls. The eosinophil percentage was significantly higher in eCRSwNP than neCRSwNP and controls. The level of IL-8 was significantly higher in neCRSwNP than in eCRSwNP and controls.Blood eosinophilia, nasal fluid eosinophilia, higher total ethmoid score / total maxillary score (E/M ratio) and higher visual analogue scale (VAS) score of CRS were associated with eCRSwNP, the area under receiver operating characteristic curve (AUC) was 0.800, 0.755, 0.703 and 0.648, respectively. Using the coefficients of multivariate regression, we set up a scoring system to predict eCRSwNP with three of the variates and the AUC was 0.883. Conclusion:ECRSwNP, neCRSwNP and healthy controls demonstrated different cytology and cytokine profiles in NF. A new preoperational multivariate prediction model for eCRSwNP with NF eosinophilia, blood eosinophilia and higher E/M ratio was established.

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“…105,157,158 In patients with asthma, nasal eosinophilia has been used as an indicator of eosinophilic asthma 159 and appeared to better predict airway (sputum) eosinophilia than blood eosinophil counts. 160…”

Section: 13 | Sinonasal Sampling Techniquesmentioning

confidence: 99%

Eosinophils—from cradle to grave

Jesenak,

Diamant,

Simon

et al. 2023

Allergy

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Over the past years, eosinophils have become a focus of scientific interest, especially in the context of their recently uncovered functions (e.g. antiviral, anti‐inflammatory, regulatory). These versatile cells display both beneficial and detrimental activities under various physiological and pathological conditions. Eosinophils are involved in the pathogenesis of many diseases which can be classified into primary (clonal) and secondary (reactive) disorders and idiopathic (hyper)eosinophilic syndromes. Depending on the biological specimen, the eosinophil count in different body compartments may serve as a biomarker reflecting the underlying pathophysiology and/or activity of distinct diseases and as a therapy‐driving (predictive) and monitoring tool. Personalized selection of an appropriate therapeutic strategy directly or indirectly targeting the increased number and/or activity of eosinophils should be based on the understanding of eosinophil homeostasis including their interactions with other immune and non‐immune cells within different body compartments. Hence, restoring as well as maintaining homeostasis within an individual's eosinophil pool is a goal of both specific and non‐specific eosinophil‐targeting therapies. Despite the overall favourable safety profile of the currently available anti‐eosinophil biologics, the effect of eosinophil depletion should be monitored from the perspective of possible unwanted consequences.

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Nasal lavage is better than blood count in predicting sputum eosinophilia

Cited by 4 publications

References 11 publications

Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD

Peripheral blood eosinophils: a surrogate marker for airway eosinophilia in stable COPD

Nasal fluid cytology and cytokine profiles of eosinophilic and non-eosinophilic chronic rhinosinusitis with nasal polyps

Eosinophils—from cradle to grave

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