Relationship between blood eosinophils and clinical characteristics in a cross-sectional study of a US population-based COPD cohort

DiSantostefano, Rachael L.; Hinds, David; Le, Hoa Van; Barnes, Neil

doi:10.1016/j.rmed.2016.01.013

Cited by 61 publications

(57 citation statements)

References 22 publications

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“…In this population, half of the participants had Eos ≥2%, which is comparable to what was observed, for example, in the WISDOM study13 but less than in several other studies of patients with COPD identified from the general population14 or clinical trials. This finding underscores the heterogeneity of COPD patients recruited in different cohorts.…”

Section: Discussionsupporting

confidence: 75%

Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

Zysman¹,

Deslée²,

Caillaud³

et al. 2017

COPD

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In patients with COPD, there is controversy regarding the association of blood eosinophil (Eos) levels with 1) exacerbation frequency and 2) the effect of inhaled corticosteroids for prevention of exacerbations. To determine whether Eos define subgroups of patients exhibiting attributes of COPD clinical phenotypes, we compared clinical features and mortality rates in COPD patients from the Initiatives BPCO French cohort categorized using different thresholds of blood Eos levels. The following data were collected at inclusion: medical and smoking history, occupational exposures, dyspnea, cough and sputum production, exacerbations in the previous year, history of allergy and asthma, nasal symptoms, body mass index, St George Respiratory Questionnaire (SGRQ) total score, post-bronchodilator spirometry, comorbidities, and medications. Three-year survival between groups was compared using Kaplan–Meier analysis. Three sets of analyses were performed to compare patients with ≥2% versus <2%, ≥3% versus <3%, and ≥4% versus <4% Eos. Eos was available in 458 patients (mean age: 62 years, 72% male, mean forced expiratory volume in 1 second: 51% pred), including 235 patients with Eos ≥2% (49%), 149 with Eos ≥3% (33%), and 90 with Eos ≥4% (20%). For all cutoffs, there was no difference between Eos+ and Eos− groups in univariate analyses except for diabetes and SGRQ score (more frequent and more impaired, respectively, in lower Eos categories). In particular, there was no difference in exacerbation rate, history of asthma, or three-year survival. In conclusion, regardless of the cutoff, Eos+ COPD patients exhibited no specific characteristic in terms of symptoms, lung function, exacerbation rate, and prognosis. These findings suggest that the association of higher Eos with exacerbations reported in previous studies could be population specific, which does not support generalizing the use of Eos as a biomarker for COPD phenotyping.

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Section: Discussionsupporting

confidence: 75%

Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

Zysman¹,

Deslée²,

Caillaud³

et al. 2017

COPD

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“…The BEC in our population is at a medium‐low level compared with that mentioned in the literature by other authors who use the same cut‐off points. More than one‐third (39.1%) of our patients have a BEC greater than 200, which is lower than the 49.4% mentioned by Hastie et al, as well as the 63.7% of the patients by Disantoestefano . Using the 300 cells/µL cut‐off point, 22.1% are equal or greater, similar to that referred to by Watz or Roche, but lower than other populations where these values increase between 32.5% and 41.4% .…”

Section: Discussionsupporting

confidence: 59%

“…High levels of blood eosinophil counts (BEC) were observed in different studies. Data from the National Health and Nutrition Examination Survey (NHANES) showed that 70% of the individuals included had a BEC greater than 2%, although this percentage is different in other populations …”

Section: Introductionmentioning

confidence: 99%

Blood eosinophils could be useful as a biomarker in chronic obstructive pulmonary disease exacerbations

Barcala

San-Jose²,

Nieto‐Fontarigo

et al. 2019

Int J Clin Pract

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Summary IntroductionThe aim of analysing the usefulness of the blood eosinophil count (BEC) as a prognostic marker in exacerbations of patients with Chronic Obstructive Pulmonary Disease (COPD), evaluating its relationship with hospital mortality, the length of stay and the early and late re‐admissions. Materials and MethodsWe have carried out a retrospective study including all patients who required hospital admission from 1 January 2008 to 31 December 2009, with a diagnosis on hospital discharge of COPD exacerbation. These patients were classified using three cut‐off points of BEC: less than 200 vs ≥ 200/µL, less than 300 vs ≥ 300/µL and less than 400 vs ≥ 400/µL. ResultsThere were a total of 1626 hospital admissions during the study period with the diagnosis of exacerbation of COPD. In this study we have included 358 patients. The probability of any late re‐admission increased with a BEC ≥ 300/µL (odds ratio: 1.684) and for those with a BEC ≥ 400/µL (odds ratio: 2.068). The BEC does not appear to be related to hospital mortality or the probability of early re‐admission after an exacerbation of COPD. ConclusionsIn our study an elevated BEC is associated with a higher incidence of late hospital readmissions in COPD exacerbations.

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“…This cut-off was chosen in accordance with former studies present in the literature showing that it may identify patients who would benefit from corticosteroids [10, 11]. In any case, in a nationally representative dataset of the US population, a blood eosinophil cell count >2% was prevalent in subjects with COPD (70.7% of participants, estimated 12.8 million of population) [16]. …”

Section: Introductionmentioning

confidence: 99%

The Time Course of Pulmonary Function Tests in COPD Patients with Different Levels of Blood Eosinophils

Rogliani

Puxeddu

Ciaprini

et al. 2016

BioMed Research International

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Only very few studies have investigated the influence of eosinophils on the functional progression of COPD. We aimed at retrospectively analyzing the trend of pulmonary function tests over time in patients with COPD according to two baseline blood eosinophil cell count strata (<2% [EOS−] and ≥2% [EOS+]). We used the last 9-year data present in the database of our outpatient clinic and selected only those who had two blood counts that would guarantee the stability of the value of eosinophils and serial spirometry for 4 consecutive years. The analysis of the time course of the spirometric variables analysed showed differences in FEV1 and FVC decline between the subjects of the EOS− group and those of the EOS+ group. The integrated evaluation of our results suggests that the different level of blood eosinophils in the two groups may have influenced independently the time course of the pulmonary function tests and identify two subgroups of subjects with specific disease characteristics: the hyperinflator and the rapid decliner, respectively.

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Relationship between blood eosinophils and clinical characteristics in a cross-sectional study of a US population-based COPD cohort

Cited by 61 publications

References 22 publications

Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

Blood eosinophils could be useful as a biomarker in chronic obstructive pulmonary disease exacerbations

The Time Course of Pulmonary Function Tests in COPD Patients with Different Levels of Blood Eosinophils

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