Alveolar eosinophilia in current smokers with chronic obstructive pulmonary disease in the SPIROMICS cohort

Martínez, Carlos H.; Li, Sara X.; Hirzel, Andrew J.; Stolberg, Valerie R.; Alexis, Neil E.; Barr, R. Graham; Bleecker, Eugene R.; Carretta, Elizabeth E.; Christenson, Stephanie A.; Cooper, Christopher B.; Couper, David J.; Doerschuk, Claire M.; Han, MeiLan K.; Hansel, Nadia N.; Hastie, Annette T.; Hoffman, Eric A.; Kaner, Robert J.; Martínez, Fernando J.; Meyers, Deborah A.; O’Neal, Wanda K.; Paine, Robert; Putcha, Nirupama; Rennard, Stephen I.; Woodruff, Prescott G.; Zeidler, Michelle; Curtis, Jeffrey L.; Freeman, Christine M.

doi:10.1016/j.jaci.2017.07.039

Cited by 17 publications

(16 citation statements)

References 9 publications

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“…For this subgroup, the levels of CRP, NLR and ESR were significantly lower, suggesting that an eosinophilic phenotype could be defined, as previous reports stated [29]. The blood EOS levels were significantly lower in active smokers versus non-smokers or former smokers, suggesting that smoking might increase the recruitment or retention of eosinophils in specific sites, perhaps in distal lung areas [30], as recently reported by Martinez et al (2018). Only for the active smokers group of our study, the patients with higher EOS levels had a greater BODE index, indicating a connection between these two parameters, both proposed as biomarkers of survival and mortality.…”

Section: Discussionsupporting

confidence: 67%

Correlations between neutrophil to lymphocyte ratio, blood eosinophils and clinical characteristics in chronic obstructive pulmonary disease

Chiș

Pop

2019

Medicine and Pharmacy Reports

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Background and aims. Chronic obstructive pulmonary disease (COPD) is currently the third leading cause of death worldwide, with increasing mortality and morbidity. The neutrophil to lymphocyte ratio (NLR) and blood eosinophils level (EOS) represent biomarkers of inflammation in various diseases, with current research in the field of COPD. The aim of this study was to determine correlations of NLR and EOS with certain characteristics of COPD in a group of patients without major comorbidities. Methods. We conducted an observational study on COPD patients admitted to the Clinical Hospital of Pneumology in Cluj-Napoca, Romania. The smoking history, body mass index (BMI), NLR, EOS, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and the arterial partial pressure of oxygen (PaO2) were determined. Functional assessment consisted of spirometric and BODE index determinations. The duration of hospitalization was expressed as the length of stay (LOS). The patients were divided into 3 subgroups: active smokers (AS), former smokers (FS) and never smokers (NS). Results. No significant differences between AS and FS were found when age, airway obstruction, BODE index, PaO2, ESR and CRP were considered. The NLR was higher in AS versus FS (p=0.035), while EOS was lower in AS group (p=0.061). COPD patients with ≥300EOS/μL had lower CRP, ESR levels and NLR compared to those with eosinophilia˂300/ μL (p=0.020, p=0.009 and p=0.007, respectively). With a threshold of 3.5 for NLR, patients with lower NLR had lower CRP values (p=0.05). COPD patients with higher NLR had significant lower EOS levels (p=0.018). Overall, the NLR and EOS were not correlated with the investigated characteristics (p˃0.05), but intragroup analysis (based on smoking status) revealed correlations with ESR (p=0.0001), CRP (p=0.053), BODE index (p=0.029) and LOS (p=0.042). Conclusions. AS have higher NLR and lower EOS lelvels versus FS. COPD patients with higher EOS level have lower CRP, ESR and NLR. In AS, EOS level is positively correlated with BODE index and negatively correlated with NLR.

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Section: Discussionsupporting

confidence: 67%

Correlations between neutrophil to lymphocyte ratio, blood eosinophils and clinical characteristics in chronic obstructive pulmonary disease

Chiș

Pop

2019

Medicine and Pharmacy Reports

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“… 68 Furthermore, the subset of patients who underwent bronchoscopy in the Subpopulations And Intermediate Outcomes in COPD Study (SPIROMICS; NCT01969344) 69 showed significantly increased BAL eosinophils for current smokers with COPD compared with former smokers with and without COPD, as well as current smokers without COPD. 70 Other large observational studies – Genetic Epidemiology of COPD (COPDGene; NCT00608764) 71 and The Novel Observational Longitudinal Study (NOVELTY; NCT02760329) 72 – that are currently under way will further characterize patients with COPD and healthy volunteers and provide more insight into the eosinophil profiles of these populations.…”

Section: Eosinophils: Characteristics and Methods Of Quantificationmentioning

confidence: 99%

Role of eosinophils in airway inflammation of chronic obstructive pulmonary disease

Tashkin

Wechsler

2018

COPD

140

113

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COPD is a significant cause of morbidity and mortality. In some patients with COPD, eosinophils contribute to inflammation that promotes airway obstruction; approximately a third of stable COPD patients have evidence of eosinophilic inflammation. Although the eosinophil threshold associated with clinical relevance in patients with COPD is currently subject to debate, eosinophil counts hold potential as biomarkers to guide therapy. In particular, eosinophil counts may be useful in assessing which patients may benefit from inhaled corticosteroid therapy, particularly regarding exacerbation prevention. In addition, several therapies targeting eosinophilic inflammation are available or in development, including monoclonal antibodies targeting the IL5 ligand, the IL5 receptor, IL4, and IL13. The goal of this review was to describe the biologic characteristics of eosinophils, their role in COPD during exacerbations and stable disease, and their use as biomarkers to aid treatment decisions. We also propose an algorithm for inhaled corticosteroid use, taking into consideration eosinophil counts and pneumonia history, and emerging eosinophil-targeted therapies in COPD.

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“…BAL fluid eosinophil counts were significantly increased in current smokers with COPD relative to those in former smokers with or without COPD, current smokers without airflow obstruction, or never smokers, whereas there was no difference between eosinophil percentages in peripheral blood and sputum. 105 Moreover, BAL fluid eosinophil counts did not correlate significantly in any sample type with FEV 1 percent predicted or imaging variables (percentage emphysema or Pi10). BAL fluid eosinophil counts showed no correlation with blood or sputum eosinophil counts.…”

Section: Biologics In Asthmatic Patientsmentioning

confidence: 74%

Advances in asthma, asthma-COPD overlap, and related biologics in 2018

Bacharier

Mori

Kita

2019

Journal of Allergy and Clinical Immunology

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Over the past year, numerous important advances in our understanding of multiple aspects of asthma, ranging from disease pathogenesis to epidemiology to therapeutics, have been reported. This review is a compilation of highlights from articles published largely in the Journal of Allergy and Clinical Immunology and supplemented by articles published elsewhere that have substantially advanced the fields of asthma, chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap and biologic therapies for these disorders. The intention of this article is not to provide a comprehensive review but rather to focus on several areas that have developed quickly and/or received extensive attention from our readers.

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Alveolar eosinophilia in current smokers with chronic obstructive pulmonary disease in the SPIROMICS cohort

Abstract: SUMMARY Active smoking in stable COPD subjects significantly increased eosinophil accumulation in the distal airspaces, but not in sputum or peripheral blood. Our findings support the need to investigate this cell-type as a potential driver of COPD symptomatology and progression.

Cited by 17 publications

References 9 publications

Correlations between neutrophil to lymphocyte ratio, blood eosinophils and clinical characteristics in chronic obstructive pulmonary disease

Correlations between neutrophil to lymphocyte ratio, blood eosinophils and clinical characteristics in chronic obstructive pulmonary disease

Role of eosinophils in airway inflammation of chronic obstructive pulmonary disease

Advances in asthma, asthma-COPD overlap, and related biologics in 2018

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