Eosinophil Subtypes in Adults with Asthma and Adults with Chronic Obstructive Pulmonary Disease

López, Carlos Cabrera; Santos, A Sánchez; Castellano, Angelina Lemes; Rivero, S Cazorla; Atienza, J. Breña; Dávila, Enrique González; Celli, Bartolomé R.; Macario, Ciro Casanova

doi:10.1164/rccm.202301-0149oc

Cited by 17 publications

(8 citation statements)

References 34 publications

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“… 61 Recent studies have discerned between inflammatory and resident eosinophil subtypes, indicating that the inflammatory eosinophils predominantly contribute to COPD associated with type-2 inflammation. 62 , 63 Therefore, inflammatory eosinophils might offer a more accurate guide than total eosinophils for corticosteroid treatment decisions. Furthermore, factors such as corticosteroid treatment prior to admission, presenting symptoms and signs, and blood gas examination results might also have potential implications for personalized corticosteroid treatments.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Nomograms Using Routine Biomarkers Beyond Eosinophil Levels: Enhancing Predictability of Corticosteroid Treatment Outcomes in AECOPD

Feng,

Li,

Qian

et al. 2024

JIR

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Purpose Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) exhibit heterogeneous responses to corticosteroid treatment. We aimed to determine whether combining eosinophil levels with other routine clinical indicators can enhance the predictability of corticosteroid treatment outcomes and to come up with a scoring system. Patients and Methods Consecutive patients admitted with AECOPD receiving corticosteroid treatment between July 2013 and March 2022 at Beijing Chao-Yang Hospital were retrospectively analyzed. Data on patients’ demographics, smoking status, hospitalization for AECOPD in the previous year, comorbidities, blood laboratory tests, in-hospital treatment and clinical outcomes were collected. Least absolute shrinkage and selection operator (LASSO) regression and backward logistic regression were used for predictor selection, and predictive nomograms were developed. The discrimination and calibration of the nomograms were assessed using the area under the receiver operating curve (AUC) and calibration plots. Internal validation was performed using the 500-bootstrap method, and clinical utility was evaluated using decision curve analysis (DCA). Results Among the 3254 patients included, 804 (24.7%) had treatment failure. A nomogram of eosinophils, platelets, C-reactive protein (CRP), low density lipoprotein cholesterol, prognostic nutritional index (PNI), hospitalization for AECOPD in the previous year, ischemic heart diseases and chronic hepatic disease was developed to predict treatment failure for patients with a smoking history. For patients without a smoking history, a nomogram of CRP, PNI, ischemic heart diseases and chronic hepatic disease was developed. Although the AUCs of these two nomograms were only 0.644 and 0.647 respectively, they were significantly superior to predictions based solely on blood eosinophil levels. Conclusion We developed easy-to-use comprehensive nomograms utilizing readily available clinical biomarkers related to inflammation, nutrition and immunity, offering modestly enhanced predictive value for treatment outcomes in corticosteroid-treated patients with AECOPD. Further investigations into novel biomarkers and additional patient data are imperative to optimize the predictive performance.

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Section: Discussionmentioning

confidence: 99%

Comprehensive Nomograms Using Routine Biomarkers Beyond Eosinophil Levels: Enhancing Predictability of Corticosteroid Treatment Outcomes in AECOPD

Feng,

Li,

Qian

et al. 2024

JIR

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“…This difference was not seen in the COPD discovery cohort, though their very low number of iEos may have compromised receptor detection. Conversely, although expression of IL-5Rα by rEos was significantly higher in COPD than in asthma in the validation cohorts, it was still lower than that of iEos in both COPD and asthma ( 13 ). IL-5Rα expression differences between eosinophil subsets in the two diseases are noteworthy, given the availability of biologicals that therapeutically target IL-5 directly or via its receptor ( 14 ).…”

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confidence: 88%

“…In this issue of the Journal , Cabrera López and colleagues (pp. 155–162 ) examined phenotypes and proportions of these eosinophil subsets in peripheral blood in four discovery cohorts ( n = 10 each): participants with allergic asthma not receiving biologicals, ever smokers with or without COPD, and healthy volunteers ( 13 ). Using a published flow cytometric approach ( 11 ), they distinguished iEos (Siglec-8 + , CD62L low , CD123 [IL-3 receptor] high ) from an alternative phenotype (Siglec-8 + , CD62L high , CD123 low ) termed rEos, although detected in blood, for consistency with previous literature.…”

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confidence: 99%

“…In the COPD validation cohort, proportions of iEos versus rEos did not differ across Global Initiative for Chronic Obstructive Lung Disease stages or by inhaled corticosteroid use. These findings were interpreted to suggest that in COPD, eosinophils (which are primarily rEos) play a lesser role in disease progression than that of iEos in asthma ( 13 ). Alternatively, peripheral blood might not accurately reflect differences in airway eosinophil subsets, which were not investigated.…”

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confidence: 99%

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Finding the Right Biological: Eosinophil Subset Differences in Asthma and Chronic Obstructive Pulmonary Disease

Freeman

Curtis

Hastie³

2023

Am J Respir Crit Care Med

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“…Studies by Cabrera Lopez et al have identified differences in eosinophil surface proteins as either 1) resident eosinophils (Siglec-8 + CD62L + IL-3R lo ) or 2) inflammatory eosinophils (iEos; Siglec-8 + CD62L lo IL-3R hi ) via flow cytometry and confocal microscopy. 45 Eosinophils do not work in isolation. They interact with other immune cells, such as microglia and T cells, which are also implicated in the immune response in schizophrenia.…”

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confidence: 99%

Eosinophils and Cognitive Impairment in Schizophrenia: A New Perspective

Obeagu,

Bluth

2024

JBM

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Schizophrenia is a complex psychiatric disorder characterized by a wide array of cognitive impairments. While research has predominantly focused on the neurological aspects of schizophrenia, emerging evidence suggests that the immune system, specifically eosinophils, may play a significant role in the cognitive deficits associated with the disorder. This review presents a novel perspective on the interplay between eosinophils and cognitive impairment in schizophrenia. Eosinophils, traditionally associated with allergic responses and inflammation, have garnered limited attention within the realm of neuropsychiatry. Recent studies have hinted at a potential link between eosinophil activation and the pathogenesis of schizophrenia. In this comprehensive review, we delve into the world of eosinophils, elucidating their nature, functions, and interactions with the immune system. We examine the cognitive deficits observed in individuals with schizophrenia and discuss existing theories on the etiology of these impairments, focusing on immune system involvement. The paper also highlights the evolving body of research that supports the idea of eosinophilic influence on schizophrenia-related cognitive deficits. Furthermore, we explore potential mechanisms through which eosinophils may exert their effects on cognitive function in schizophrenia, including interactions with other immune cells and inflammatory pathways. By discussing the clinical implications and potential therapeutic avenues stemming from this newfound perspective, we underscore the practical significance of this emerging field of research. While this paper acknowledges the limitations and challenges inherent in studying eosinophils within the context of schizophrenia, it serves as a posit for novel thought in this vexing disease space as well as a call to action for future research endeavors. By providing a comprehensive survey of the existing literature and posing unanswered questions, we aim to inspire a reimagining of the relationship between eosinophils and cognitive impairment in schizophrenia, ultimately advancing our understanding and treatment of this debilitating disorder.

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Eosinophil Subtypes in Adults with Asthma and Adults with Chronic Obstructive Pulmonary Disease

Cited by 17 publications

References 34 publications

Comprehensive Nomograms Using Routine Biomarkers Beyond Eosinophil Levels: Enhancing Predictability of Corticosteroid Treatment Outcomes in AECOPD

Comprehensive Nomograms Using Routine Biomarkers Beyond Eosinophil Levels: Enhancing Predictability of Corticosteroid Treatment Outcomes in AECOPD

Finding the Right Biological: Eosinophil Subset Differences in Asthma and Chronic Obstructive Pulmonary Disease

Eosinophils and Cognitive Impairment in Schizophrenia: A New Perspective

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