TY - JOUR
T1 - Stability in eosinophil categorisation during subsequent severe exacerbations of COPD
AU - Citgez, Emanuel
AU - Van Der Palen, Job
AU - Van Der Valk, Paul
AU - Kerstjens, Huib A.M.
AU - Brusse-Keizer, Marjolein
N1 - Funding Information:
Funding The COMIC Study was supported by the Department of Pulmonology, Medisch Spectrum Twente, and by an unrestricted grant from GlaxoSmithKline. The sponsor had no role in the design of the study, the collection and analysis of the data or the preparation of the manuscript.
Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/8/9
Y1 - 2021/8/9
N2 - Background The blood eosinophil count has been shown to be a promising biomarker for establishing personalised treatment strategies to reduce corticosteroid use, either inhaled or systemic, in chronic obstructive pulmonary disease (COPD). Eosinophil levels seem relatively stable over time in stable state, but little is known whether this is also true in subsequent severe acute exacerbations of COPD (AECOPD). Aims and objectives To determine the stability in eosinophil categorisation between two subsequent severe AECOPDs employing frequently used cut-off levels. Methods During two subsequent severe AECOPDs, blood eosinophil counts were determined at admission to the hospital in 237 patients in the Cohort of Mortality and Inflammation in COPD Study. The following four cut-off levels were analysed: absolute counts of eosinophils ≥0.2×10⁹ /L (200 cells/μL) and ≥0.3×10⁹ /L (300 cells/μL) and relative eosinophil percentage of ≥2% and ≥3% of total leucocyte count. Categorisations were considered stable if during the second AECOPD their blood eosinophil status led to the same classification: eosinophilic or not. Results Depending on the used cut-off, the overall stability in eosinophil categorisation varied between 70% and 85% during two subsequent AECOPDs. From patients who were eosinophilic at the first AECOPD, 34%-45% remained eosinophilic at the subsequent AECOPD, while 9%-21% of patients being non-eosinophilic at the first AECOPD became eosinophilic at the subsequent AECOPD. Conclusions The eosinophil variability leads to category changes in subsequent AECOPDs, which limits the eosinophil categorisation stability. Therefore, measurement of eosinophils at each new exacerbation seems warranted.
AB - Background The blood eosinophil count has been shown to be a promising biomarker for establishing personalised treatment strategies to reduce corticosteroid use, either inhaled or systemic, in chronic obstructive pulmonary disease (COPD). Eosinophil levels seem relatively stable over time in stable state, but little is known whether this is also true in subsequent severe acute exacerbations of COPD (AECOPD). Aims and objectives To determine the stability in eosinophil categorisation between two subsequent severe AECOPDs employing frequently used cut-off levels. Methods During two subsequent severe AECOPDs, blood eosinophil counts were determined at admission to the hospital in 237 patients in the Cohort of Mortality and Inflammation in COPD Study. The following four cut-off levels were analysed: absolute counts of eosinophils ≥0.2×10⁹ /L (200 cells/μL) and ≥0.3×10⁹ /L (300 cells/μL) and relative eosinophil percentage of ≥2% and ≥3% of total leucocyte count. Categorisations were considered stable if during the second AECOPD their blood eosinophil status led to the same classification: eosinophilic or not. Results Depending on the used cut-off, the overall stability in eosinophil categorisation varied between 70% and 85% during two subsequent AECOPDs. From patients who were eosinophilic at the first AECOPD, 34%-45% remained eosinophilic at the subsequent AECOPD, while 9%-21% of patients being non-eosinophilic at the first AECOPD became eosinophilic at the subsequent AECOPD. Conclusions The eosinophil variability leads to category changes in subsequent AECOPDs, which limits the eosinophil categorisation stability. Therefore, measurement of eosinophils at each new exacerbation seems warranted.
KW - COPD epidemiology
KW - COPD exacerbations
KW - eosinophil biology
KW - pulmonary eosinophilia
UR - http://www.scopus.com/inward/record.url?scp=85112554270&partnerID=8YFLogxK
U2 - 10.1136/bmjresp-2021-000960
DO - 10.1136/bmjresp-2021-000960
M3 - Article
C2 - 34376399
AN - SCOPUS:85112554270
VL - 8
JO - BMJ open respiratory research
JF - BMJ open respiratory research
SN - 2052-4439
IS - 1
M1 - e000960
ER -