Stability in eosinophil categorisation during subsequent severe exacerbations of COPD

Citgez, Emanuel; Palen, Job van der; Valk, Paul van der; Kerstjens, Huib A. M.; Brusse-Keizer, Marjolein

doi:10.1136/bmjresp-2021-000960

Cited by 7 publications

(3 citation statements)

References 21 publications

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“…For this interesting phenomenon, the specific mechanism is still unclear and controversial. It is speculated that although eosinophil is related to exacerbations, patients with high eosinophil are sensitive to inhaled corticosteroid (ICS) ( 43 ), thus have a better response to therapy resulting in quicker recovery ( 13 ). Secondly, it was found that lower eosinophilic COPD patients had higher neutrophil counts.…”

Section: Discussionmentioning

confidence: 99%

Using inflammatory index to distinguish asthma, asthma-COPD overlap and COPD: A retrospective observational study

Yang

Liu

et al. 2022

Front. Med.

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BackgroundAlthough asthma and chronic obstructive pulmonary disease (COPD) are two well-defined and distinct diseases, some patients present combined clinical features of both asthma and COPD, particularly in smokers and the elderly, a condition termed as asthma-COPD overlap (ACO). However, the definition of ACO is yet to be established and clinical guidelines to identify and manage ACO remain controversial. Therefore, in this study, inflammatory biomarkers were established to distinguish asthma, ACO, and COPD, and their relationship with the severity of patients’ symptoms and pulmonary function were explored.Materials and methodsA total of 178 patients, diagnosed with asthma (n = 38), ACO (n = 44), and COPD (n = 96) between January 2021 to June 2022, were enrolled in this study. The patients’ pulmonary function was examined and routine blood samples were taken for the analysis of inflammatory indexes. Logistic regression analysis was used to establish inflammatory biomarkers for distinguishing asthma, ACO, and COPD; linear regression analysis was used to analyze the relationship between inflammatory indexes and symptom severity and pulmonary function.ResultThe results showed that, compared with ACO, the higher the indexes of platelet, neutrophil-lymphocyte ratio (NLR) and eosinophil-basophil ratio (EBR), the more likely the possibility of asthma and COPD in patients, while the higher the eosinophils, the less likely the possibility of asthma and COPD. Hemoglobin and lymphocyte-monocyte ratio (LMR) were negatively correlated with the severity of patients’ symptoms, while platelet-lymphocyte ratio (PLR) was negatively correlated with forced expiratory volume in the 1 s/forced vital capacity (FEV1/FVC) and FEV1 percent predicted (% pred), and EBR was positively correlated with FEV1% pred.ConclusionInflammatory indexes are biomarkers for distinguishing asthma, ACO, and COPD, which are of clinical significance in therapeutic strategies and prognosis evaluation.

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Section: Discussionmentioning

confidence: 99%

Using inflammatory index to distinguish asthma, asthma-COPD overlap and COPD: A retrospective observational study

Yang

Liu

et al. 2022

Front. Med.

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“… 11 Citgez et al analyzed the EOS of patients hospitalized for AECOPD on two occasions before and after, based on cut-off values of 200/ul, 300/ul, 2%, and 3%, respectively, and showed overall stability of EOS of 70–85%. 12 We chose a cut-off value of 150 cells/ul because studies have shown that this value is more useful for assessing the stability of blood EOS and also for differentiating patients prone to deterioration. 13 , 14 Our results showed that the stability of blood EOS was 77.2%, suggesting that the stability of blood EOS in patients hospitalized with AECOPD was relatively stable over 1 year.…”

Section: Discussionmentioning

confidence: 99%

Stability of Blood Eosinophils in COPD with Multiple Acute Exacerbations Within 1 Year and Its Relationship with Prognosis

Gong

Sun

2022

COPD

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Background:The relationship between increased blood eosinophils (EOS) and the prognosis of patients with chronic obstructive pulmonary disease (COPD) remains controversial. We aimed to explore the stability of blood eosinophils in patients with multiple hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) over a 1-year period and its relationship with readmission rates and mortality. Methods: Prospectively include patients with at least 2 hospitalizations for AECOPD in 1 year between June 2019 and December 2021. Using 150 cells/ul as the cut-off value, the study population was divided into EOS, non-EOS, and fluctuating groups based on the longitudinal stability of blood EOS. The relationship between blood EOS and readmission rate and mortality was analyzed according to the 6-month follow-up after hospital discharge. Results: A total of 202 patients were included. 48, 108, and 46 patients were in the EOS, non-EOS, and fluctuating groups, respectively. The stability of blood EOS at 1 year was 77.2%. The risk of death was lower in the EOS group compared to the non-EOS group (HR=0.323, 95% CI 0.113-0.930, P =0.036). The risk of readmission was lower in both the EOS group (HR=0.486, 95% CI 0.256-0.923, P =0.027) and the non-EOS group (HR=0.575, 95% CI 0.347-0.954, P = 0.032) than in the fluctuating group. Conclusion:The blood EOS of COPD patients is relatively stable over 1 year. Patients with consistently high blood EOS had a lower risk of all-cause mortality after discharge; patients with fluctuating blood EOS had a higher risk of readmission.

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“…Even if asthma control in patients is stable, the blood eosinophil counts still fluctuate substantially ( 16 ). In contrast, while blood eosinophils are stable over time in stable COPD, the counts are unstable in severe acute exacerbation of COPD (AECOPD) because of the variety of causes of AECOPD ( 17 ).…”

Section: ．Relationship Between Blood Eosinophilia and Clinical Outcom...mentioning

confidence: 99%

Measurement of Blood Eosinophils in Asthma and Chronic Obstructive Pulmonary Disease

Hirano

Matsunaga

2023

Intern. Med.

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Eosinophils are important effector cells in airway inflammation, as pleiotropy and heterogeneity can be linked to various pathophysiologies in asthma and chronic obstructive pulmonary disease (COPD). Sputum eosinophils can reflect the heterogeneity of airway inflammation, and owing to their traits, blood eosinophils can be a surrogate and potential biomarker for managing both conditions. Blood eosinophils are activated via the stimulation of type 2 cytokines, such as interleukin (IL)-5, IL-4/13, granulocyte-macrophage colonystimulating factor, IL-33, and thymic stromal lymphopoietin. There is sufficient evidence to support the relationship between the blood eosinophil count and clinical outcomes, including pulmonary function decline, exacerbations, all-cause mortality, and treatment response to inhaled corticosteroids and biologics. Thus, there is growing interest in the use of blood eosinophils for the management of these diseases. Compiling recent evidence, we herein review the significance of measuring blood eosinophils in asthma and COPD.

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Stability in eosinophil categorisation during subsequent severe exacerbations of COPD

Cited by 7 publications

References 21 publications

Using inflammatory index to distinguish asthma, asthma-COPD overlap and COPD: A retrospective observational study

Using inflammatory index to distinguish asthma, asthma-COPD overlap and COPD: A retrospective observational study

Stability of Blood Eosinophils in COPD with Multiple Acute Exacerbations Within 1 Year and Its Relationship with Prognosis

Measurement of Blood Eosinophils in Asthma and Chronic Obstructive Pulmonary Disease

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