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

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.	黄玉娴, 孔庆瑜, 蔡高荣, 等. 三种检测嗜酸性粒细胞方法的比较. 现代医学仪器与应用, 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.	许燕燕, 吴俊庆, 刘超群, 等. 不同方法检测外周血嗜酸性粒细胞计数准确性比较. 中国基层医药, 2010, 17(21): 2903-2904.
20.	朱丽英, 郁施青, 马爽, 等. 全自动血液分析仪 CD3700 与显微镜直接计数嗜酸性细胞比较. 检验医学与临床, 2013, 10(4): 483-484.
21.	张亮, 吴振安, 付慧哲. 全自动血细胞分析仪白细胞分类计数与手工分类计数结果一致性的比较分析. 中国临床医生杂志, 2016, 44(4): 96-98.
22.	金虹新. CD-3700 全自动血细胞分析仪测定结果影响因素分析. 医药前沿, 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. 黄玉娴, 孔庆瑜, 蔡高荣, 等. 三种检测嗜酸性粒细胞方法的比较. 现代医学仪器与应用, 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. 许燕燕, 吴俊庆, 刘超群, 等. 不同方法检测外周血嗜酸性粒细胞计数准确性比较. 中国基层医药, 2010, 17(21): 2903-2904.
20. 朱丽英, 郁施青, 马爽, 等. 全自动血液分析仪 CD3700 与显微镜直接计数嗜酸性细胞比较. 检验医学与临床, 2013, 10(4): 483-484.
21. 张亮, 吴振安, 付慧哲. 全自动血细胞分析仪白细胞分类计数与手工分类计数结果一致性的比较分析. 中国临床医生杂志, 2016, 44(4): 96-98.
22. 金虹新. CD-3700 全自动血细胞分析仪测定结果影响因素分析. 医药前沿, 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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