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ABSTRACT
Sputum and blood eosinophils are proposed as candidate biomarkers for the identification of chronic obstructive pulmonary disease (COPD) patients at risk for exacerbation and treatment response. In this study, we evaluated the associations of eosinophils with the presence of emphysema in COPD patients. Induced sputum and blood eosinophil measurements were performed in consecutive COPD patients. Patients underwent lung function testing and high resolution computed tomography (HRCT) of the chest and the presence of emphysema was quantified. Patients with emphysematous lesions in ≥15% of the pulmonary parenchyma were considered having significant emphysema. Ninety-eight patients were included in the study. Patients with significant emphysema had lower blood eosinophil counts compared to patients without emphysema [median (IQR) 34.6 (0.0, 63.0) vs. 169.0 (110.0, 260.0) cells/µL, p < 0.001]; similar results were observed for the percentage (%) of blood eosinophils, but no difference was observed for sputum eosinophils. The differences were evident in frequent and non-frequent exacerbators and irrespective of the use of inhaled corticosteroids (ICS). Patients with significant emphysema in HRCT present lower levels of blood eosinophils and these differences were present irrespective of the frequent exacerbator history or the use of ICS. Blood eosinophils may not represent a clinically relevant biomarker in the presence of emphysema.
Abbreviations
| BMI | = | Body Mass Index |
| COPD | = | Chronic Obstructive Pulmonary Disease |
| DLCO | = | Diffusing Lung Capacity for Carbon Monoxide |
| FEF25–75 | = | Forced Expiratory Flow in the middle 50% of FVC |
| FEV1 | = | Forced Exhaled Volume in one second |
| FVC | = | Forced Exhaled Vital Capacity |
| GOLD | = | Global Initiative for Chronic Obstructive Lung Disease |
| HRCT | = | High Resolution Computed Tomography |
| ICS | = | Inhaled Corticosteroids |
| IQR | = | Interquartile Range |
| LABA | = | Long Acting Beta Agonists |
| LAMA | = | Long Acting Muscarining Antagonists |
| VA | = | Alveolar Volume |
Declaration of interest
Konstantinos Kostikas is a Novartis employee. All other authors declare that they have no conflict of interest related to the present manuscript. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Acknowledgments
PB, SL, NK, and SP designed the study; AIP, KK, and SL wrote the manuscript; AIP, KK, and SL performed the data analysis; AP, LA, EP, and GH collected the data; AM has performed the emphysema scoring in the HRCT. SL and PB are the paper guarantors. All authors have read and approved the final version of the manuscript.