Eosinophils as diagnostic tools in chronic lung disease

Eltboli, Osama; Brightling, Christopher E.

doi:10.1586/ers.12.81

Cited by 51 publications

(48 citation statements)

References 93 publications

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“…Both of them are considered as chronic airway inflammatory diseases, typically associated with Th2-mediated immune response in asthma and related to the characteristic of Th1-mediated immunity in COPD 1. Subsequently, while eosinophilic airway inflammation is the hallmark feature of airway inflammation in asthma, COPD is typically associated with a neutrophilic response in airway inflammation, which is often because of bacterial colonization.…”

Section: Introductionmentioning

confidence: 99%

Correlation between fractional exhaled nitric oxide and sputum eosinophilia in exacerbations of COPD

Gao¹,

Zhang

Zhou³

et al. 2017

COPD

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IntroductionMeasurements of eosinophils in induced sputum and fractional exhaled nitric oxide (FeNO) are noninvasive biomarkers for assessing airway inflammation phenotypes in chronic obstructive pulmonary disease (COPD). Nevertheless, the clinical application of the correlation between FeNO levels and sputum eosinophilia is controversial. The study aimed to investigate the correlation and predictive relationship between FeNO levels and sputum eosinophils in patients with COPD exacerbation. It also examined the relationship between FeNO levels and blood eosinophil percentage.MethodsA total of 163 patients with COPD exacerbation were included in the cross-sectional study. All patients underwent the following on the same day: FeNO test, spirometry, bronchodilator reversibility test, induced sputum, and routine blood test. They were classified as eosinophilic group or noneosinophilic group based on sputum eosinophilic percentage (≥2.5%)/FeNO levels (≥32 parts per billion [ppb]).ResultsFeNO levels and blood eosinophilic percentage were higher in patients with sputum eosinophilia (n=62) compared to those without (31.35 ppb versus 21.43 ppb, P=0.015; 2.71% versus 0.98%, P<0.0001, respectively). Sputum eosinophilic percentage was higher with raised FeNO (n=34) compared to those with FeNO <32 ppb (5.12% versus 3.12%, P=0.007). Eosinophils in induced sputum correlated with both FeNO levels (ρ=0.221, P=0.005) and blood eosinophilic percentage (ρ=0.399, P<0.001). There was no relationship between FeNO and blood eosinophilic percentage. Blood eosinophilic percentage was predictive of sputum eosinophilia (95% confidence interval [CI] =0.65–0.81, P<0.001) at a cutoff point of 0.65% (sensitivity =73%, specificity =61.3%). FeNO levels were predictive of sputum eosinophilia (95% CI =0.53–3,071, P=0.012) at a cutoff point of 17.5 ppb (sensitivity =65.1%, specificity =56.4%).ConclusionThe clinical relevance of this study provides evidence that inflammatory biomarkers, including sputum eosinophilic percentage, FeNO level, and blood eosinophilic percentage, can be used to positively diagnose eosinophilic COPD. The FeNO level and blood eosinophilic counts/percentage, which determine an optimal cutoff for sputum eosinophilia, need more studies.

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Section: Introductionmentioning

confidence: 99%

Correlation between fractional exhaled nitric oxide and sputum eosinophilia in exacerbations of COPD

Gao¹,

Zhang

Zhou³

et al. 2017

COPD

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“…Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition exemplified by the identification of a subgroup of COPD subjects with eosinophilic airway inflammation [1,2]. The role of eosinophilic inflammation in COPD remains controversial, but is consistently reported in 10-30% of COPD subjects and is associated with better responses to inhaled and oral corticosteroids [3,4].…”

Section: Introductionmentioning

confidence: 99%

COPD exacerbation severity and frequency is associated with impaired macrophage efferocytosis of eosinophils

et al. 2014

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BackgroundEosinophilic airway inflammation is observed in 10-30% of COPD subjects. Whether increased eosinophils or impairment in their clearance by macrophages is associated with the severity and frequency of exacerbations is unknown.MethodsWe categorised 103 COPD subjects into 4 groups determined by the upper limit of normal for their cytoplasmic macrophage red hue (<6%), an indirect measure of macrophage efferocytosis of eosinophils, and area under the curve sputum eosinophil count (≥3%/year). Eosinophil efferocytosis by monocyte-derived macrophages was studied in 17 COPD subjects and 8 normal controls.ResultsThere were no differences in baseline lung function, health status or exacerbation frequency between the groups: A-low red hue, high sputum eosinophils (n = 10), B-high red hue, high sputum eosinophils (n = 16), C-low red hue, low sputum eosinophils (n = 19) and D- high red hue, low sputum eosinophils (n = 58). Positive bacterial culture was lower in groups A (10%) and B (6%) compared to C (44%) and D (21%) (p = 0.01). The fall in FEV1 from stable to exacerbation was greatest in group A (ΔFEV1 [95 % CI] -0.41 L [-0.65 to -0.17]) versus group B (-0.16 L [-0.32 to -0.011]), C (-0.11 L [-0.23 to -0.002]) and D (-0.16 L [-0.22 to -0.10]; p = 0.02). Macrophage efferocytosis of eosinophils was impaired in COPD versus controls (86 [75 to 92]% versus 93 [88 to 96]%; p = 0.028); was most marked in group A (71 [70 to 84]%; p = 0.0295) and was inversely correlated with exacerbation frequency (r = -0.63; p = 0.006).ConclusionsMacrophage efferocytosis of eosinophils is impaired in COPD and is related to the severity and frequency of COPD exacerbations.

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“…In the Dose Ranging Efficacy And safety with Mepolizumab study the peripheral blood eosinophil count correlated with response to the anti‐interleukin (IL)‐5 monoclonal antibody mepolizumab 6. The success of anti‐IL5 in subjects with severe asthma with evidence of eosinophilic inflammation1 raises the possibility that blood eosinophils might be an appropriate biomarker to direct eosinophil‐specific therapy in COPD. Indeed, a recent report does suggest that the peripheral blood eosinophil count identifies a subgroup of COPD subjects that have the greatest benefit in terms of lung function, health status and exacerbations in response to anti‐IL‐5‐receptor, Benralizumab 7…”

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Relationship between blood and bronchial submucosal eosinophilia and reticular basement membrane thickening in chronic obstructive pulmonary disease

et al. 2015

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A sputum eosinophilia is observed in 10–40% of COPD subjects. The blood eosinophil count is a biomarker of sputum eosinophilia, but whether it is associated with bronchial submucosal eosinophils is unclear. In 20 COPD subjects and 21 controls we assessed the number of bronchial submucosal eosinophils and reticular basement membrane thickening and found these were positively correlated with the blood eosinophil percentage. In COPD, blood eosinophils are a good biomarker of bronchial eosinophilia and remodelling.

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Eosinophils as diagnostic tools in chronic lung disease

Cited by 51 publications

References 93 publications

Correlation between fractional exhaled nitric oxide and sputum eosinophilia in exacerbations of COPD

Correlation between fractional exhaled nitric oxide and sputum eosinophilia in exacerbations of COPD

COPD exacerbation severity and frequency is associated with impaired macrophage efferocytosis of eosinophils

Relationship between blood and bronchial submucosal eosinophilia and reticular basement membrane thickening in chronic obstructive pulmonary disease

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