Clinical significance of blood eosinophils in patients with acute exacerbation of chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

FEI Fan , WU Zhenzhen , ZHU Manni , XU Tingting , ZHU Ranran , MA Yuan , JI Ningfei ,  HUANG Mao

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P. R. China;

Corresponding?author：

HUANG Mao, Email: hm6114@126.com

Keywords：

Acute exacerbation of chronic obstructive pulmonary disease; Eosinophil

DOI：

10.7507/1671-6205.201903016

Video：

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Objective To analyze the features and clinical significance of blood eosinophils (EOS) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods The general data, laboratory examination and treatment of patients with AECOPD admitted to this department from January 2014 to December 2016 were analyzed retrospectively. Based on the inclusion of treatment targets for blood EOS according to 2018GOLD, patients were divided into group A (EOS<100 cells/μL), group B (100 cells/μL≤EOS≤300 cells/μL), and group C (EOS>300 cells/μL) with two cut-off levels. The differences in general data, severity, and glucocorticoid use between group A, group B and group C were compared.Results A total of 515 patients with AECOPD were enrolled. 10.87% of patients had blood EOS>300 cells/μL, and 39.03% of patients had blood EOS≥100 cells/μL. Patients in group B and C were younger, with shorter disease duration, intensive care unit stay time, non-invasive mechanical ventilation use time. The time of glucocorticoid administration was significantly shortened, and the cumulative dose of venous glucocorticoid, hospitalization cost, and total drug cost were also lower than those of group A (all P<0.05).Conclusions Patients in group B and C are younger, shorter in disease duration, lower in severity and more responsive to glucocorticoid therapy. Blood EOS can be used as a marker to guide glucocorticoid therapy in patients with AECOPD.

Citation： FEI Fan, WU Zhenzhen, ZHU Manni, XU Tingting, ZHU Ranran, MA Yuan, JI Ningfei, HUANG Mao. Clinical significance of blood eosinophils in patients with acute exacerbation of chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(5): 418-422. doi: 10.7507/1671-6205.201903016 Copy

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2.	Saha S, Brightling CE. Eosinophilic airway inflammation in COPD. Int J Chron Obstruct Pulmon Dis, 2006, 1(1): 39-47.
3.	黃玉嫻, 孔慶瑜, 蔡高榮, 等. 三種檢測嗜酸性粒細胞方法的比較. 現代醫學儀器與應用, 2004, 16(3): 9-11.
4.	Bafadhel M, Mckenna S, Terry S, et al. Acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2011, 184(6): 662-671.
5.	Gao P, Zhang J, He X, et al. Sputum inflammatory cell-based classification of patients with acute exacerbation of chronic obstructive pulmonary disease. PLoS One, 2013, 8(5): e57678-e.
6.	Hasegawa K, Camargo CA Jr. Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD. Respirology, 2016, 21(4): 761-764.
7.	Barnes NC. Inhaled steroids in COPD. Lancet, 1998, 351(9105): 766-767.
8.	Gibson PG, Dolovich J, Denburg J, et al. Chronic cough: eosinophilic bronchitis without asthma. Lancet, 1989, 333(8651): 1346-1348.
9.	Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med, 2006, 173(10): 1114-1121.
10.	Bafadhel M, Greening NJ, Harvey-Dunstan TC, et al. Blood eosinophils and outcomes in severe hospitalized exacerbations of COPD. Chest, 2016, 150(2): 320-328.
11.	Saltürk C, Karakurt Z, Adiguzel N, et al. Does eosinophilic COPD exacerbation have a better patient outcome than non-eosinophilic in the intensive care unit?. Int J Chron Obstruct Pulmon Dis, 2015, 10: 1837-1846.
12.	Yun JH, Lamb A, Chase R, et al. Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol, 2018, 141(6): 2037-2047.
13.	Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease 2017 report. Available at: https://goldcopd.org/.
14.	Pascoe S, Locantore N, Dransfield MT, et al. Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomized controlled trials. Lancet Respir Med, 2015, 3(6): 435-442.
15.	Siddiqui SH, Guasconi A, Vestbo J, et al. Blood eosinophils: a biomarker of response to extrafine beclomethasone/formoterol in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2015, 192(4): 523-525.
16.	Bafadhel M, Peterson S, De Blas MA, et al. Predictors of exacerbation risk and response to budesonide in patients with chronic obstructive pulmonary disease: a post-hoc analysis of three randomized trials. Lancet Respir Med, 2018, 6(2): 117-126.
17.	Watz H, Tetzlaff K, Wouters EF, et al. Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial. Lancet Respir Med, 2016, 4(5): 390-398.
18.	Magnussen H, Watz H, Zimmermann I, et al. Peak inspiratory flow through the Genuair? inhaler in patients with moderate or severe COPD. Respir Med, 2009, 103(12): 1832-1837.
19.	許燕燕, 吳俊慶, 劉超群, 等. 不同方法檢測外周血嗜酸性粒細胞計數準確性比較. 中國基層醫藥, 2010, 17(21): 2903-2904.
20.	朱麗英, 郁施青, 馬爽, 等. 全自動血液分析儀 CD3700 與顯微鏡直接計數嗜酸性細胞比較. 檢驗醫學與臨床, 2013, 10(4): 483-484.
21.	張亮, 吳振安, 付慧哲. 全自動血細胞分析儀白細胞分類計數與手工分類計數結果一致性的比較分析. 中國臨床醫生雜志, 2016, 44(4): 96-98.
22.	金虹新. CD-3700 全自動血細胞分析儀測定結果影響因素分析. 醫藥前沿, 2014, (4): 269-270.

1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease 2018 report. Available at: https://goldcopd.org/.
2. Saha S, Brightling CE. Eosinophilic airway inflammation in COPD. Int J Chron Obstruct Pulmon Dis, 2006, 1(1): 39-47.
3. 黃玉嫻, 孔慶瑜, 蔡高榮, 等. 三種檢測嗜酸性粒細胞方法的比較. 現代醫學儀器與應用, 2004, 16(3): 9-11.
4. Bafadhel M, Mckenna S, Terry S, et al. Acute exacerbations of chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2011, 184(6): 662-671.
5. Gao P, Zhang J, He X, et al. Sputum inflammatory cell-based classification of patients with acute exacerbation of chronic obstructive pulmonary disease. PLoS One, 2013, 8(5): e57678-e.
6. Hasegawa K, Camargo CA Jr. Prevalence of blood eosinophilia in hospitalized patients with acute exacerbation of COPD. Respirology, 2016, 21(4): 761-764.
7. Barnes NC. Inhaled steroids in COPD. Lancet, 1998, 351(9105): 766-767.
8. Gibson PG, Dolovich J, Denburg J, et al. Chronic cough: eosinophilic bronchitis without asthma. Lancet, 1989, 333(8651): 1346-1348.
9. Papi A, Bellettato CM, Braccioni F, et al. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med, 2006, 173(10): 1114-1121.
10. Bafadhel M, Greening NJ, Harvey-Dunstan TC, et al. Blood eosinophils and outcomes in severe hospitalized exacerbations of COPD. Chest, 2016, 150(2): 320-328.
11. Saltürk C, Karakurt Z, Adiguzel N, et al. Does eosinophilic COPD exacerbation have a better patient outcome than non-eosinophilic in the intensive care unit?. Int J Chron Obstruct Pulmon Dis, 2015, 10: 1837-1846.
12. Yun JH, Lamb A, Chase R, et al. Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease. J Allergy Clin Immunol, 2018, 141(6): 2037-2047.
13. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease 2017 report. Available at: https://goldcopd.org/.
14. Pascoe S, Locantore N, Dransfield MT, et al. Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomized controlled trials. Lancet Respir Med, 2015, 3(6): 435-442.
15. Siddiqui SH, Guasconi A, Vestbo J, et al. Blood eosinophils: a biomarker of response to extrafine beclomethasone/formoterol in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2015, 192(4): 523-525.
16. Bafadhel M, Peterson S, De Blas MA, et al. Predictors of exacerbation risk and response to budesonide in patients with chronic obstructive pulmonary disease: a post-hoc analysis of three randomized trials. Lancet Respir Med, 2018, 6(2): 117-126.
17. Watz H, Tetzlaff K, Wouters EF, et al. Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial. Lancet Respir Med, 2016, 4(5): 390-398.
18. Magnussen H, Watz H, Zimmermann I, et al. Peak inspiratory flow through the Genuair? inhaler in patients with moderate or severe COPD. Respir Med, 2009, 103(12): 1832-1837.
19. 許燕燕, 吳俊慶, 劉超群, 等. 不同方法檢測外周血嗜酸性粒細胞計數準確性比較. 中國基層醫藥, 2010, 17(21): 2903-2904.
20. 朱麗英, 郁施青, 馬爽, 等. 全自動血液分析儀 CD3700 與顯微鏡直接計數嗜酸性細胞比較. 檢驗醫學與臨床, 2013, 10(4): 483-484.
21. 張亮, 吳振安, 付慧哲. 全自動血細胞分析儀白細胞分類計數與手工分類計數結果一致性的比較分析. 中國臨床醫生雜志, 2016, 44(4): 96-98.
22. 金虹新. CD-3700 全自動血細胞分析儀測定結果影響因素分析. 醫藥前沿, 2014, (4): 269-270.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical significance of blood eosinophils in patients with acute exacerbation of chronic obstructive pulmonary disease

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