Clinical implications of correlation between peripheral eosinophil count and serum levels of IL-5 and tryptase in acute eosinophilic pneumonia

Jhun, Byung Woo; Kim, Se Jin; Kim, Kang; Lee, Ji Eun; Hong, Duck Jin

doi:10.1016/j.rmed.2014.09.011

Cited by 26 publications

(19 citation statements)

References 23 publications

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“…Table 1 presents the commonly reported clinical characteristics of our cohort in comparison with six AEP case series with at least 20 patients [2,4,21,23,25,29]. At least five papers have been published on AEP patients at the Armed Forces Capital Hospital in South Korea [21][22][23]29,30] and we chose to include [21,23,29] as these papers did not overlap with each other by dates and therefore patient populations. Most of our patients were male (91%) and young with an average age of 25.5 years.…”

Section: Resultsmentioning

confidence: 99%

“…AEP should be considered for all patients with an acute respiratory illness and pulmonary infiltrates on chest radiograph in which a cause is not immediately apparent. Clinical clues which should raise the clinician's suspicion for this diagnosis include a recent initiation or escalation in cigarette smoking [3][4][5][6][7][8][9][10][11][12], progressive peripheral eosinophilia during the first few days of evaluation [2,[28][29][30][31] and severe respiratory failure without other major organ involvement [31].…”

Section: Discussionmentioning

confidence: 99%

“…The degree of peripheral eosinophilia at presentation has been associated with a milder disease course [2,29,30]. Recently, cigarette smoking-related AEP was associated with less peripheral eosinophilia and a more severe presentation compared to drug-induced AEP [2].…”

Section: Discussionmentioning

confidence: 99%

“…Jhun [29] and Philit [25] describe grouped subsets of patients, peripheral eosinophilia vs no peripheral eosinophilia and early presenting vs late presenting patients, and in both comparison groups the group with the higher average BAL eosinophilia also had higher average PaO 2 /FiO 2 ratios. Taken together, these separate reports bring into question the role of eosinophilia in AEP [30]. Does it play a primary inflammatory role, does it initiate an inflammatory cascade, is it merely a response to injury, or is it a marker of disease recovery?…”

Section: Discussionmentioning

confidence: 99%

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Acute eosinophilic pneumonia in the deployed military setting

Sine

Hiles

Scoville

et al. 2018

Respiratory Medicine

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Based on our experience and literature review, we recommend adjustments to the diagnostic criteria which may increase consideration of this etiology for acute respiratory illnesses as well as provide clinical clues we have found particularly helpful. Similar to recent reports of initial peripheral eosinophilia correlating with less severe presentation we found that higher BAL eosinophilia correlated with less severe hypoxemia.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute eosinophilic pneumonia in the deployed military setting

Sine

Hiles

Scoville

et al. 2018

Respiratory Medicine

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“…The exact mechanism of this association has not been revealed; however, it may be associated with cytokines, such as interleukin (IL)-5, which have an inverse correlation with PEC [19]. As IL-5 is an important mediator of recruitment of eosinophils from peripheral blood into the lungs, a decrease in IL-5 may attenuate eosinophilic inflammation in the lung.…”

Section: Discussionmentioning

confidence: 99%

Association between peripheral blood/bronchoalveolar lavage eosinophilia and significant oxygen requirements in patients with acute eosinophilic pneumonia

et al. 2020

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Background: We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP). Methods: We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cutoff value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2). Results: Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO 2 /FiO 2 ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cutoff level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements. Conclusions: In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.

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The Role and Immunobiology of Eosinophils in the Respiratory System: a Comprehensive Review

Eng

DeFelice

2016

Clinic Rev Allerg Immunol

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The eosinophil is a fully delineated granulocyte that disseminates throughout the bloodstream to end-organs after complete maturation in the bone marrow. While the presence of eosinophils is not uncommon even in healthy individuals, these granulocytes play a central role in inflammation and allergic processes. Normally appearing in smaller numbers, higher levels of eosinophils in the peripheral blood or certain tissues typically signal a pathologic process. Eosinophils confer a beneficial effect on the host by enhancing immunity against molds and viruses. However, tissue-specific elevation of eosinophils, particularly in the respiratory system, can cause a variety of short-term symptoms and may lead to long-term sequelae. Eosinophils often play a role in more commonly encountered disease processes, such as asthma and allergic responses in the upper respiratory tract. They are also integral in the pathology of less common diseases including eosinophilic pneumonia, allergic bronchopulmonary aspergillosis, hypersensitivity pneumonitis, and drug reaction with eosinophilia and systemic symptoms. They can be seen in neoplastic disorders or occupational exposures as well. The involvement of eosinophils in pulmonary disease processes can affect the method of diagnosis and the selection of treatment modalities. By analyzing the complex interaction between the eosinophil and its environment, which includes signaling molecules and tissues, different therapies have been discovered and created in order to target disease processes at a cellular level. Innovative treatments such as mepolizumab and benralizumab will be discussed. The purpose of this article is to further explore the topic of eosinophilic presence, activity, and pathology in the respiratory tract, as well as discuss current and future treatment options through a detailed literature review.

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Clinical implications of correlation between peripheral eosinophil count and serum levels of IL-5 and tryptase in acute eosinophilic pneumonia

Cited by 26 publications

References 23 publications

Acute eosinophilic pneumonia in the deployed military setting

Acute eosinophilic pneumonia in the deployed military setting

Association between peripheral blood/bronchoalveolar lavage eosinophilia and significant oxygen requirements in patients with acute eosinophilic pneumonia

The Role and Immunobiology of Eosinophils in the Respiratory System: a Comprehensive Review

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