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).
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.
CITA DEL ARTÍCULO Eur Respir J. 2017 Nov 22;50(5). pii: 1701162. doi: 10.1183/13993003.01162-2017