Prevalence and Baseline Clinical Characteristics of Eosinophilic Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review

Wu, Hongxia; Zhuo, Kai-Quan; Cheng, Donghui

doi:10.3389/fmed.2019.00282

Cited by 19 publications

(19 citation statements)

References 41 publications

(76 reference statements)

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“…On the other hand, some baseline clinical characteristics of COPD according to eosinophil levels have also been reported. Recent meta-analysis revealed that men, exsmokers, individuals with a history of ischemic heart disease, and individuals with a higher body mass index (BMI) were at higher risk of eosinophilic COPD [48]. Regarding more COPD-specific health outcome measures, the findings of the SPIROMICS cohort showed that at baseline, the high blood eosinophil group had slightly increased airway wall thickness, higher SGRQ Symptom scores, and increased wheezing, but no evidence of an association with the other indices of COPD severity, such as emphysema measured by CT density or the CAT [47].…”

Section: Discussionmentioning

confidence: 99%

Is Blood Eosinophil Count a Biomarker for Chronic Obstructive Pulmonary Disease in a Real-World Clinical Setting? Predictive Property and Longitudinal Stability in Japanese Patients

et al. 2021

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The authors examined predictive properties and the longitudinal stability of blood eosinophil count (BEC) or three strata (<100 cells/mm3, 100–299 cells/mm3 and ≥300 cells/mm3) in patients with chronic obstructive pulmonary disease (COPD) for up to six and a half years as part of a hospital-based cohort study. Of the 135 patients enrolled, 21 (15.6%) were confirmed to have died during the follow-up period. Episodes of acute exacerbation of COPD (AECOPD) were identified in 74 out of 130 available patients (56.9%), and admission due to AECOPD in 35 out of 132 (26.5%). Univariate Cox proportional hazards analyses revealed that almost all the age, forced expiratory volume in 1 s (FEV1) and health status measures using St. George’s Respiratory Questionnaire (SGRQ) Total and COPD Assessment Test (CAT) Score were significantly related to these types of events, but the relationship between age and AECOPD did not reach statistical significance (p = 0.05). Neither BEC nor the three different groups stratified by BEC were significant predictors of any subsequent events. There were no significant differences in the BEC between Visits 1–3 (p = 0.127, Friedman test). The ICC value was 0.755 using log-transformed data, indicating excellent repeatability. In the case of assigning to strata, Fleiss’ kappa was calculated to be 0.464, indicating moderate agreement. The predictive properties of BEC may be limited in a real-world Japanese clinical setting. Attention must be paid to the fact that the longitudinal stability of the three strata is regarded as moderate.

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Section: Discussionmentioning

confidence: 99%

Is Blood Eosinophil Count a Biomarker for Chronic Obstructive Pulmonary Disease in a Real-World Clinical Setting? Predictive Property and Longitudinal Stability in Japanese Patients

et al. 2021

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“…Eosinophilic exacerbations have been observed both in COPD and AECOPD patients and represent a novel pathological mechanism of a special clinical phenotype in COPD. Previous studies have explored the relationship between blood eosinophil counts over time and in‐hospital management outcomes, 31 and reported an association between COPD patients with persistently increased blood eosinophil counts and better outcomes. Furthermore, evidence from randomised clinical trials has shown that patient blood eosinophil counts are crucial for predicting a good response to corticosteroid administration 32,33 …”

Section: Discussionmentioning

confidence: 99%

Eosinophilic phenotype was associated with better early clinical remission in elderly patients but not middle‐aged patients with acute exacerbations of COPD

Zeng

Wang

et al. 2021

Int J Clin Pract

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Background There is limited evidence of the relationship between peripheral blood eosinophils and clinical remission of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at different ages, especially in elderly patients, which was the objective of the present study. Methods This retrospective study stratified patients by age (elderly patients >65 years old or middle‐aged patients between 45 and 65 years old) and analysed the relationship between blood eosinophils (≥2% or <2%) and AECOPD clinical remission at observing time points of 7, 14, 21 and 28 days of hospitalisation. Student's t tests, Mann–Whitney U tests, Chi‐squared or Fisher's exact tests were conditionally used to compare difference between groups. The unadjusted or adjusted Cox proportional hazards model was used to analyse the association between blood eosinophilic levels and cumulative clinical remission. Results Of 703 AECOPD cases analysed, 616 were elderly people (>65 years), 312 of whom had eosinophilic exacerbations. There were statistically significant differences in leucocytes, eosinophils, neutrophils, lymphocytes, monocytes, high‐sensitivity C‐reactive protein levels (hs‐CRP), and hospital costs between groups (P < .05, respectively). According to the chi‐square analysis, eosinophilic exacerbation had a higher clinical remission rate at 7, 14 and 21 days (all P < .05), but not 28 days (P > .05). Among analysis through adjusted Cox proportional hazards model, eosinophilic exacerbation was significantly associated with a higher cumulative remission rate in elderly patients at 7, 14, 21 days (all P < .05), but not 28 days (P > .05). No significant association was observed in meddle‐aged patients at any time points (all P > .05). Conclusion Eosinophilic exacerbation was associated with better early clinical remission of AECOPD patients during hospitalisation. As stratified by ages, similar results were observed in elderly patients but not middle‐aged patients. Blood eosinophils at different ages may be valuable in personalised management for AECOPD.

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“…Subsequent infiltration of eosinophils in the airways of COPD patients regulates the immunoglobulin E (IgE)-dependent mechanism, which is con-sidered as an important part of Th2 cell cytokine production process [32], with an irregular Th1/Th2 ratio and interleukin-17/IgE ratio that may be caused by imbalanced Th2 cell production [33]. Previous clinical trials have explored the relationship between blood eosinophil counts over time and in-hospital management outcomes [16]. Eosinophilia has been observed both in COPD and AECOPD patients and represents a novel pathological mechanism of a special clinical phenotype in COPD.…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, blood eosinophil count, an easy-to-use and easy-to-measure index which is economically efficient and provides rapid results, has been identified to be capable of measuring inflammatory response in AECOPD patients [14,15]. The prevalence of eosinophilic COPD varies widely in different countries and regions, from 18.84% to 66.88%, with an average prevalence of 54.95% [16]. Compelling evidence has confirmed that patients with higher sputum or peripheral blood eosinophil counts are not only associated with better corticosteroid response and lower rate of AECOPD treatment failure [17,18] but also with lower risk of all-cause mortality [19].…”

Section: Introductionmentioning

confidence: 99%

Eosinophilic phenotype was associated with better clinical remission in elderly but not middle-aged patients with acute exacerbations of COPD

Zeng

Wang

et al. 2020

Preprint

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Background: There is limited evidence of the relationship between peripheral blood eosinophilia and clinical remission of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) at different ages, especially in elderly patients, which was the objective of the present study. Methods: This retrospective study stratified patients by age (>65 or [?]65 years) and analyzed the relationship between blood eosinophilia ([?]2% or <2%) and AECOPD clinical remission at observing time points of 7, 10, 14, 21, and 28 days. Results: Of 703 AECOPD cases analyzed, 616 were elderly (>65 years), 272 of whom had eosinophilic exacerbations. There were statistically significant differences in leukocyte count, high-sensitivity C-reactive protein levels (hs-CRP), and overall and daily hospital costs between eosinophilic and non-eosinophilic AECOPD patients (p<0.05, respectively). In the overall analysis, eosinophilic exacerbation was significantly associated with a higher remission rate at 7 (hazard ratio [

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Prevalence and Baseline Clinical Characteristics of Eosinophilic Chronic Obstructive Pulmonary Disease: A Meta-Analysis and Systematic Review

Cited by 19 publications

References 41 publications

Is Blood Eosinophil Count a Biomarker for Chronic Obstructive Pulmonary Disease in a Real-World Clinical Setting? Predictive Property and Longitudinal Stability in Japanese Patients

Is Blood Eosinophil Count a Biomarker for Chronic Obstructive Pulmonary Disease in a Real-World Clinical Setting? Predictive Property and Longitudinal Stability in Japanese Patients

Eosinophilic phenotype was associated with better early clinical remission in elderly patients but not middle‐aged patients with acute exacerbations of COPD

Eosinophilic phenotype was associated with better clinical remission in elderly but not middle-aged patients with acute exacerbations of COPD

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