Blood eosinophil count as a prognostic biomarker in COPD

Oh, Yeon Mok; Lee, Keu Sung; Hong, Yoonki; Hwang, Sung Chul; Kim, Jae Yeol; Kim, Deog Kyeom; Yoo, Kwang Ha; Lee, Ji Hyun; Kim, Tae Hyung; Lim, Seong Yong; Rhee, Chin Kook; Yoon, Hyoung Kyu; Lee, Sang Yeub; Park, Yong Bum; Jung, Jin Hee; Kim, Woo Jin; Lee, Sang Do; Park, Joo Hun

doi:10.2147/copd.s179734

Cited by 28 publications

(28 citation statements)

References 32 publications

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“… 29 , 30 Population-based studies included MESA (African American, non-Hispanic white, Hispanic, and Chinese participants), 31 , 32 Cardiovascular Health Study (CHS; African American and European ancestry participants), 33 the Rotterdam Study (all three cohorts), 34 and a study by Kangwon University. 35 For lung-function growth patterns, we did an analysis using individuals in the Childhood Asthma Management Program (CAMP). 18 CAMP was a randomised placebo-controlled trial of anti-inflammatory treatments in 1041 children with mild-to-moderate asthma (aged 5–12 years at enrolment), with 13 years of follow-up and low attrition (≤20%).…”

Section: Methodsmentioning

confidence: 99%

Chronic obstructive pulmonary disease and related phenotypes: polygenic risk scores in population-based and case-control cohorts

Moll

Sakornsakolpat

Shrine

et al. 2020

The Lancet Respiratory Medicine

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Summary Background Genetic factors influence chronic obstructive pulmonary disease (COPD) risk, but the individual variants that have been identified have small effects. We hypothesised that a polygenic risk score using additional variants would predict COPD and associated phenotypes. Methods We constructed a polygenic risk score using a genome-wide association study of lung function (FEV 1 and FEV 1 /forced vital capacity [FVC]) from the UK Biobank and SpiroMeta. We tested this polygenic risk score in nine cohorts of multiple ethnicities for an association with moderate-to-severe COPD (defined as FEV 1 /FVC <0·7 and FEV 1 <80% of predicted). Associations were tested using logistic regression models, adjusting for age, sex, height, smoking pack-years, and principal components of genetic ancestry. We assessed predictive performance of models by area under the curve. In a subset of studies, we also studied quantitative and qualitative CT imaging phenotypes that reflect parenchymal and airway pathology, and patterns of reduced lung growth. Findings The polygenic risk score was associated with COPD in European (odds ratio [OR] per SD 1·81 [95% CI 1·74–1·88] and non-European (1·42 [1·34–1·51]) populations. Compared with the first decile, the tenth decile of the polygenic risk score was associated with COPD, with an OR of 7·99 (6·56–9·72) in European ancestry and 4·83 (3·45–6·77) in non-European ancestry cohorts. The polygenic risk score was superior to previously described genetic risk scores and, when combined with clinical risk factors (ie, age, sex, and smoking pack-years), showed improved prediction for COPD compared with a model comprising clinical risk factors alone (AUC 0·80 [0·79–0·81] vs 0·76 [0·75–0·76]). The polygenic risk score was associated with CT imaging phenotypes, including wall area percent, quantitative and qualitative measures of emphysema, local histogram emphysema patterns, and destructive emphysema subtypes. The polygenic risk score was associated with a reduced lung growth pattern. Interpretation A risk score comprised of genetic variants can identify a small subset of individuals at markedly increased risk for moderate-to-severe COPD, emphysema subtypes associated with cigarette smoking, and patterns of reduced lung growth. Funding US National Institutes of Health, Wellcome Trust.

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Section: Methodsmentioning

confidence: 99%

Chronic obstructive pulmonary disease and related phenotypes: polygenic risk scores in population-based and case-control cohorts

Moll

Sakornsakolpat

Shrine

et al. 2020

The Lancet Respiratory Medicine

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“…Some previous studies also showed similar results. 5,[11][12][13] However, another study from France revealed there was no association of increased blood eosinophils and mortality of COPD patients regardless of the cutoff values. 14 There might be some reasons which can explain these discrepancies: most importantly, blood eosinophils naturally fluctuate over time and are affected by many factors.…”

Section: Discussionmentioning

confidence: 97%

“…The study subjects from our study and Li et al 13 were patients hospitalized for AECOPD, Salturk et al 5 study subjects were patients who were admitted to ICU with acute respiratory failure, while other studies' subjects were from stable COPD patients. 11,12,14 In addition, whether patients suffering with asthma were included or not may affect study results.…”

Section: Discussionmentioning

confidence: 99%

“…At present, the relationship between blood eosinophilia at index hospitalization and mortality of COPD patients is controversial. [11][12][13][14] Further studies showed blood eosinophil counts were susceptible to many factors and had variability throughout the course of COPD [15][16][17][18][19][20] and using only one measurement of blood eosinophil count may not be a reliable predictor of COPD clinical outcome. Presently, there is no general consensus on the cutoff value for categorizing blood eosinophils to guide management of COPD patients.…”

Section: Introductionmentioning

confidence: 99%

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<p>Blood Eosinophilia and Its Stability in Hospitalized COPD Exacerbations are Associated with Lower Risk of All-Cause Mortality</p>

Zhang

Liang

Zhang

et al. 2020

COPD

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Peripheral blood eosinophilic counts are susceptible to many factors and have variability over time. There are limited studies on association of blood eosinophilia with long-term mortality of chronic obstructive pulmonary disease (COPD) patients and these results remain controversial. Our aims were to explore the association of blood eosinophilia at index hospitalization and stability of blood eosinophilia stability over 5 years with all-cause mortality of patients hospitalized for acute exacerbation of COPD (AECOPD). Patients and Methods: Eight hundred twenty-nine patients hospitalized for AECOPD between 2013 and 2014 were included in this study and grouped into two groups according to blood eosinophil with 150 cells/μL used as the cutoff value to form eosinophilic and noneosinophilic groups. Two hundred forty-one COPD inpatients with at least three blood eosinophils measured from different hospitalizations were used for analysis of longitudinally eosinophilic stability and divided into three groups according to the same cutoff value: predominantly (PE), intermittently (IE) and rarely (RE) eosinophilic groups. Cox regression analysis was used to determine the association of blood eosinophilia and all-cause mortality. Results: In patients hospitalized for AECOPD, 261 (31.5%) at baseline and 41 (17%) based on at least three measurements of blood eosinophils had increased blood eosinophils. For all-cause mortality, eosinophilic COPD patients at index hospitalization had a lower all-cause mortality compared with non-eosinophilic COPD patients (hazard ratio 0.77, 95% confidence interval 0.6-0.99, P=0.04). In patients readmitted for AECOPD by longitudinal eosinophil stability, with the RE group used as reference, the PE group was associated with a lower all-cause mortality of AECOPD patients (hazard ratio 0.43, 95% confidence interval 0.22-0.85, P=0.016), compared to the IE group (hazard ratio 0.72, 95% confidence interval 0.47-1.11, P=0.133). Conclusion: Patients with increased eosinophils (using eosinophil 150 cells/μL as a cutoff value), especially predominantly increased eosinophil levels based on multiple measurements, had a lower risk of all-cause mortality. Blood eosinophilia can be used as a biomarker in hospitalized COPD exacerbations for predicting the risk of all-cause mortality.

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“…Eosinophils are key innate immune cells in host defence [3], and they have been found to be associated with mortality in patients with chronic obstructive pulmonary disease (COPD) [4,5] and asthma [6,7]. The blood eosinophil count (EOS) is considered a potential biomarker for the identi cation of COPD patients at risk and as a reference for the usage of inhaled corticosteroids, as recommended by the GOLD 2019 guidelines [8].…”

Section: Introductionmentioning

confidence: 99%

Blood Eosinophils and Mortality in Patients With Acute Respiratory Distress Syndrome: A Propensity Score Matching Analysis

Chen

Mao

et al. 2020

Preprint

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Background: The effect of blood eosinophils on mortality in acute respiratory distress syndrome (ARDS) patients and whether this effect is impacted by corticosteroids are unclear. This study explored the relationship between blood eosinophils and 28-day mortality in ARDS patients and investigated whether the relationship varied according to corticosteroid use.Methods: The Medical Information Mart for Intensive Care III database was employed to extract data. Patients with ARDS who were 16 years or older, used mechanical ventilation during the ICU stay and stayed in the ICU for at least 48 consecutive hours were screened for inclusion. Cox regression models using the stepwise backward method and propensity score matching (PSM) were employed to assess the relationship between blood eosinophil counts and 28-day mortality.Result: A total of 3372 patients were included, and the 28-day mortality rate was 24.23% (817/3372). The crude 28-day mortality was significantly lower in patients with eosinophil count ≥2% (105/574 vs. 712/2798, p< 0.001) than in those with eosinophil count <2%. In the Cox regression model, the eosinophil count ≥2% showed a significant association with decreased 28-day mortality (hazard ratio (HR) 0.761; 95% confidence interval (CI) =0.620-0.935, p=0.009). In a subgroup analysis, we detected an interactive effect of eosinophils and corticosteroids use (p value for interaction, p=0.006). In the corticosteroid non-use subgroup, eosinophil counts ≥2% were significantly related to decreased 28-day mortality (HR=0.730, 95% CI =0.577-0.923), but the result was non-significant in the corticosteroid non-use subgroup model (p=0.231). A total of 574 well-matched pairs were obtained by a 1:1 matching algorithm after PSM. The 28-day mortality remained significantly lower in the eosinophil count ≥2% group than in the eosinophil count <2% group (105/574 vs 136/574, p=0.025).Conclusions: Higher eosinophil counts are related to lower 28-day mortality in ARDS patients, and this relationship can be counteracted by using corticosteroids.

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Blood eosinophil count as a prognostic biomarker in COPD

Cited by 28 publications

References 32 publications

Chronic obstructive pulmonary disease and related phenotypes: polygenic risk scores in population-based and case-control cohorts

Chronic obstructive pulmonary disease and related phenotypes: polygenic risk scores in population-based and case-control cohorts

<p>Blood Eosinophilia and Its Stability in Hospitalized COPD Exacerbations are Associated with Lower Risk of All-Cause Mortality</p>

Blood Eosinophils and Mortality in Patients With Acute Respiratory Distress Syndrome: A Propensity Score Matching Analysis

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