Prediction value of neutrophil and eosinophil count at risk of COPD exacerbation

Abstract

Introduction

Predicting acute exacerbations (AEs) in chronic obstructive pulmonary disease (COPD) is crucial. This study aimed to identify blood biomarkers for predicting COPD exacerbations by inflammatory phenotypes.

Materials and methods

We analyzed blood cell counts and clinical outcomes in 340 COPD patients aged 20–90 years. Patients were categorized into eosinophilic inflammation (EOCOPD) and non-eosinophilic inflammation (N-EOCOPD) groups. Blood cell counts, eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-eosinophil ratio (NER) were calculated. Linear and logistic regression models assessed relationships between health outcomes and blood cell counts.

Results

EOCOPD patients had distinct characteristics compared to N-EOCOPD patients. Increased neutrophil % and decreased lymphocyte % were associated with reduced pulmonary function, worse quality of life and more exacerbations, but they did not show statistical significance after adjusting by age, sex, BMI, smoking status, FEV1% and patient’s medication. Subgroup analysis revealed a 1.372-fold increase in the OR of AE for every 1 unit increase in NLR in EOCOPD patients (p < .05). In N-EOCOPD patients, every 1% increase in blood eosinophil decreased the risk of exacerbation by 59.6%.

Conclusions

Our study indicates that distinct white blood cell profiles in COPD patients, with or without eosinophilic inflammation, can help assess the risk of AE in clinical settings.

Keywords:

• Acute exacerbation
• COPD
• eosinophil
• inflammation
• neutrophil

Acknowledgements

The authors would like to express sincere appreciation to the thoracic departments of Wan Fang Hospital and Taipei Medical University Hospital for their technical assistance during this research.

Author contributions

Tzu-Tao Chen: the drafting of the paper. Huan Minh Tran, Amja Manullang, Shu-Chuan Ho and Sheng-Ming Wu: analysis and interpretation of the data. Jer-Hwa Chang, Chi-Li Chung, Kuan-Yuan Chen and Chien-Hua Tseng: data collection. Kang-Yun Lee and Hsiao-Chi Chuang: conception and design of the work. All authors have read and approved the final version of the manuscript for publication.

Disclosure statement

The authors declare that they have no conflicts of interest.

Data availability statement

Data available on request from the authors.

Additional information

Funding

This study was funded by the National of Science and Technology Council of Taiwan [112-2314-B-038-013 and 112-2628-B-038-010-MY3] and Taipei Medical University [TMU112-AE1-B05].