Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD
Casanova C (1), Celli BR (2), de-Torres JP (3), Martínez-Gonzalez C (4), Cosio BG (5,6), Pinto-Plata V (7), de Lucas-Ramos P (8), Divo M (2), Fuster A (9), Peces-Barba G (6,10), Calle-Rubio M (11), Solanes I (12), Aguero R (13), Feu-Collado N (14), Alfageme I (15), De Diego A (16), Romero A (17), Balcells E (18), Llunell A (19), Galdiz JB (20), Marin M (21), Moreno A (2)2, Cabrera C 23, Golpe R (24), Lacarcel C (25), Soriano JB (26), López-Campos JL (6,27), Soler-Cataluña JJ (28), Marin JM (29).
(1) Pulmonary Dept, Hospital Universitario Ntra Sra de La Candelaria, Tenerife, Spain
(2) Pulmonary and Critical Care Dept, Brigham and Women's Hospital, Boston, MA, USA.
(3) Pulmonary Dept, Clínica Universidad de Navarra, Pamplona, Spain.
(4) Pulmonary Dept, Hospital Central de Asturias, Oviedo, Spain.
(5) Pulmonary Dept, Hospital Son Espases-IdISPa, Palma de Mallorca, Spain.
(6) CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
(7) Baystate Medical Center, Springfield, MA, USA.
(8) Pulmonary Dept I, Hospital Gregorio Marañón, Madrid, Spain.
(9) Pulmonary Dept, Hospital Son Llátzer, Mallorca, Spain.
(10) Pulmonary Dept, Fundación Jimenez Díaz, Madrid, Spain.
(11) Pulmonary Dept, Hospital Clínico San Carlos, Medicine Dept, Faculty of Medicine, University Complutense of Madrid, Madrid, Spain.
(12) Pulmonary Dept, Hospital Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain.
(13) Pulmonary Dept, Hospital Marqués de Valdecilla, Santander, Spain.
(14) Pulmonary Dept, Hospital Universitario Reina Sofia, IMIBIC, UCO, Córdoba, Spain.
(15) Pulmonary Dept, Hospital Universitario de Valme, Sevilla, Spain.
(16) Pulmonary Dept, Hospital Universitario de la Fe, Valencia, Spain.
(17) Pulmonary Dept, Hospital de Manacor, Mallorca, Spain.
(18) Pulmonary Dept, Hospital del Mar, Barcelona, Spain.
(19) Pulmonary Dept, Hospital de Tarrasa, Tarrasa, Spain.
(20) Pulmonary Dept, Hospital de Cruces, Bilbao, Spain.
(21) Pulmonary Dept, Hospital General de Castellon, Castellon, Spain.
(22) Pulmonary Dept, Hospital Parc Tauli, Sabadell, Barcelona, Spain.
(23) Pulmonary Dept, Hospital Dr Negrín, Las Palmas de Gran Canaria, Spain.
(24) Pulmonary Dept, Hospital Universitario Lucus Augusti, Lugo, Spain.
(25) Pulmonary Dept, Hospital Ciudad de Jaén, Jaén, Spain.
(26) Instituto de Investigación, Hospital Universitario de la Princesa-IISP, Madrid, Spain.
(27)Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, Spain.
(28) Pulmonary Dept, Hospital Arnau de Vilanova, Valencia, Spain.
(29) Pulmonary Dept, Hospital Universitario Miguel Servet, IISAragon, CIBERES, Zaragoza, Spain.
The impact of blood eosinophilia in chronic obstructive pulmonary disease (COPD) remains controversial.
To evaluate the prevalence and stability of a high level of blood eosinophils (≥300 cells·μL-1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis.
In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels <300 cells·μL-1
A similar eosinophil blood pattern was observed in controls. Exacerbation rates did not differ in patients with and without eosinophilia. All-cause mortality was lower in patients with high eosinophils compared with those with values <300 cells·μL-1 (15.8% versus 33.7%; p=0.026).In patients with COPD, blood eosinophils ≥300 cells·μL-1 persisting over 2 years was not a risk factor for COPD exacerbations. High eosinophil count was associated with better survival.