Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease

Jeong H Yun; Andrew Lamb; Robert Chase; Dave Singh; Margaret M Parker; Aabida Saferali; Jørgen Vestbo; Ruth Tal-Singer; Peter J Castaldi; Edwin K Silverman; Craig P Hersh; COPDGene and ECLIPSE Investigators

doi:10.1016/j.jaci.2018.04.010

Back

Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease

Journal article

Open access

Peer reviewed

Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease

Jeong H Yun, Andrew Lamb, Robert Chase, Dave Singh, Margaret M Parker, Aabida Saferali, Jørgen Vestbo, Ruth Tal-Singer, Peter J Castaldi, Edwin K Silverman, …

Journal of allergy and clinical immunology, Vol.141(6), pp.2037-2047.e10

06/2018

DOI: 10.1016/j.jaci.2018.04.010

PMCID: PMC5994197

PMID: 29709670

Files and links (1)

url

https://doi.org/10.1016/j.jaci.2018.04.010View

Published (Version of record) Open Access

Abstract

Eosinophilic airway inflammation in patients with chronic obstructive pulmonary disease (COPD) is associated with exacerbations and responsivity to steroids, suggesting potential shared mechanisms with eosinophilic asthma. However, there is no consistent blood eosinophil count that has been used to define the increased exacerbation risk. We sought to investigate blood eosinophil counts associated with exacerbation risk in patients with COPD. Blood eosinophil counts and exacerbation risk were analyzed in patients with moderate-to-severe COPD by using 2 independent studies of former and current smokers with longitudinal data. The Genetic Epidemiology of COPD (COPDGene) study was analyzed for discovery (n = 1,553), and the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study was analyzed for validation (n = 1,895). A subset of the ECLIPSE study subjects were used to assess the stability of blood eosinophil counts over time. COPD exacerbation risk increased with higher eosinophil counts. An eosinophil count threshold of 300 cells/μL or greater showed adjusted incidence rate ratios for exacerbations of 1.32 in the COPDGene study (95% CI, 1.10-1.63). The cutoff of 300 cells/μL or greater was validated for prospective risk of exacerbation in the ECLIPSE study, with adjusted incidence rate ratios of 1.22 (95% CI, 1.06-1.41) using 3-year follow-up data. Stratified analysis confirmed that the increased exacerbation risk associated with an eosinophil count of 300 cells/μL or greater was driven by subjects with a history of frequent exacerbations in both the COPDGene and ECLIPSE studies. Patients with moderate-to-severe COPD and blood eosinophil counts of 300 cells/μL or greater had an increased risk exacerbations in the COPDGene study, which was prospectively validated in the ECLIPSE study.

Humans

Middle Aged

Pulmonary Disease, Chronic Obstructive - blood

Observational Studies as Topic

Female

Male

Aged

Eosinophils - pathology

Leukocyte Count

Longitudinal Studies

Disease Progression

Details

Title: Subtitle: Blood eosinophil count thresholds and exacerbations in patients with chronic obstructive pulmonary disease
Creators: Jeong H Yun - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
Andrew Lamb - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
Robert Chase - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
Dave Singh - University of Manchester, Manchester, United Kingdom
Margaret M Parker - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
Aabida Saferali - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
Jørgen Vestbo - University of Manchester, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
Ruth Tal-Singer - GlaxoSmithKline R&D, King of Prussia, Pa
Peter J Castaldi - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
Edwin K Silverman - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
Craig P Hersh - Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass. Electronic address: craig.hersh@channing.harvard.edu
COPDGene and ECLIPSE Investigators
Contributors: Alejandro P Comellas (Contributor) - University of Iowa, Internal Medicine
Resource Type: Journal article
Publication Details: Journal of allergy and clinical immunology, Vol.141(6), pp.2037-2047.e10
DOI: 10.1016/j.jaci.2018.04.010
PMID: 29709670
PMCID: PMC5994197
NLM abbreviation: J Allergy Clin Immunol
ISSN: 0091-6749
eISSN: 1097-6825
Grant note: P30 ES005605 / NIEHS NIH HHS T32 HL007427 / NHLBI NIH HHS U01 HL089897 / NHLBI NIH HHS R01 HL125583 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS R01 HL124233 / NHLBI NIH HHS K08 HL141601 / NHLBI NIH HHS R01 HL130512 / NHLBI NIH HHS R01 HL126596 / NHLBI NIH HHS U01 HL089856 / NHLBI NIH HHS P01 HL105339 / NHLBI NIH HHS R01 HL089897 / NHLBI NIH HHS P01 HL132825 / NHLBI NIH HHS K12 HL120004 / NHLBI NIH HHS
Language: English
Date published: 06/2018
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
Record Identifier: 9984094511402771

Metrics

32 Record Views

191 Times Cited - Web of Science