scholarly journals Prevalence of Asthma and COPD and Blood Eosinophil Count in a Middle-Aged Belgian Population

2019 ◽  
Vol 8 (8) ◽  
pp. 1122 ◽  
Author(s):  
Sara R. A. Wijnant ◽  
Lies Lahousse ◽  
Marc L. De Buyzere ◽  
Guy G. Brusselle ◽  
Ernst R. Rietzschel
Keyword(s):  
Eosinophil Count ◽  
Respiratory Health ◽  
Disease Status ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Middle Aged ◽  
Blood Eosinophil Count ◽  
Current Asthma ◽  
Airway Diseases ◽  
Obstructive Airway Diseases

Various phenotypes exist in asthma and Chronic Obstructive Pulmonary Disease (COPD). These are important to identify in order to guide treatment decisions. We aim to investigate the prevalence and clinical characteristics of obstructive airway diseases in the middle-aged population. We estimated the prevalence of COPD and/or asthma in the Asklepios cohort study (Belgium), using information from the third European Community Respiratory Health Survey (ECRHS3), medical records, and spirometry. Respiratory symptoms, respiratory medication, and current disease status distinguished clinical from sub-clinical cases. In addition, we compared the blood eosinophil count/µL (median [IQR]) between cases and controls. Of the 2221 participants (mean age 56.1 ± 5.9 years; 48.7% males), 138 (6.2%) participants had clinical current asthma, 22 (1.0%) participants had sub-clinical ever asthma, 102 (4.6%) had sub-clinical spirometry-defined COPD, 104 (4.6%) participants had clinical spirometry-confirmed COPD, and 11 (0.5%) had asthma and COPD overlap (ACO). Clinical current asthma (160.0 [110.0–250.0]), sub-clinical ever asthma (170.0 [110.0–230.0]), and clinical COPD (160.0 [110.0–220.0])—but less sub-clinical COPD (140.0 [90.0–210.0])—had higher eosinophil counts, compared to controls (130.0 [80.0–200.0]). We conclude that obstructive airway diseases are prevalent in the middle-aged Asklepios cohort. Moreover, the systemic eosinophil count is increased in clinical COPD cases, and in asthma cases regardless of clinical remission.

Absolute Blood Eosinophil Counts to Guide Inhaled Corticosteroids Therapy Among Patients with COPD: Systematic Review and Meta-analysis

2019 ◽  
Vol 20 (16) ◽  
pp. 1670-1679 ◽  
Author(s):  
Olorunfemi A. Oshagbemi ◽  
Jephthah O. Odiba ◽  
Abraham Daniel ◽  
Ismaeel Yunusa
Keyword(s):  
Systematic Review ◽  
Eosinophil Count ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Copd Patients ◽  
Phenotypic Group ◽  
Increased Risk ◽  
Eosinophil Counts

Introduction: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2019 recommends the use of absolute blood eosinophil count as a guide for the escalation and de-escalation of inhaled corticosteroids (ICS) in the pharmacological management of patients with chronic obstructive pulmonary disease (COPD). We evaluated the risk of moderate or severe exacerbations among patients escalating and de-escalating ICS therapy by absolute blood eosinophil thresholds in this systematic review. Methods: Through a comprehensive literature search of Pubmed/MEDLINE, EMBASE, and clinical trial sites up to April 2019, we identified relevant studies. We used generic inverse variance method with fixed-effects estimates to compare the risk of moderate or severe exacerbations among COPD patients with elevated blood eosinophil counts exposed to inhaled corticosteroids (ICS) versus non-ICS treatments groups expressed as risk ratios. Results: Ten studies (8 randomised control trials and 2 observational studies) were included, with a total of 85,059 COPD patients. In our pooled analysis, we found an overall reduction in risk of moderate or severe exacerbations in patients with absolute blood eosinophil thresholds ranging from ≥ 100 to ≥ 340 cells/µL among patients escalating ICS (RR, 0.77, 95% CI, 0.73-0.81). For studies evaluating the effects of de-escalation of ICS on moderate to severe exacerbations using blood eosinophil thresholds of ≥ 300 to ≥ 340 cells/µL had an increased risk of moderate or severe exacerbations following the de-escalation of ICS (RR, 1.66, 95% CI, 1.31-2.10). Conclusion: This study confirms the validity of the recommended absolute blood eosinophil count thresholds for the escalation and de-escalation of ICS among COPD patients. However, this recommendation is for COPD patients with prior exacerbations rather than among newly diagnosed COPD patients as observed in this study. COPD patients with current or past history of asthma represent a unique phenotypic group which should be further evaluated.

Prevalence of Asthma-COPD Overlap in COPD and Severe Asthma Cohorts

2021 ◽  
Author(s):  
Hyonsoo Joo ◽  
So-Young Park ◽  
So Young Park ◽  
Seo Young Park ◽  
Sang-Heon Kim ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Eosinophil Count ◽  
Clinical Manifestations ◽  
Forced Expiratory Volume ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Bronchodilator Response

Abstract Background: Asthma and chronic obstructive pulmonary disease (COPD) are airway diseases with similar clinical manifestations, despite differences in pathophysiology. Asthma-COPD overlap (ACO) is a condition characterized by overlapping clinical features of both diseases. There have been few reports regarding the prevalence of ACO in COPD and severe asthma cohorts. ACO is heterogeneous; patients can be classified on the basis of phenotype differences. This study was performed to analyze the prevalence of ACO in COPD and severe asthma cohorts. In addition, this study compared baseline characteristics among ACO patients according to phenotype.Methods: Patients with COPD were prospectively enrolled into the Korean COPD subgroup study (KOCOSS) cohort. Patients with severe asthma were prospectively enrolled into the Korean Severe Asthma Registry (KoSAR). ACO was defined in accordance with the updated Spanish criteria. In the COPD cohort, ACO was defined as bronchodilator response (BDR) ≥ 15% and ≥ 400 mL from baseline or blood eosinophil count ≥ 300 cells/μL. In the severe asthma cohort, ACO was defined as age ≥ 35 years, smoking ≥ 10 pack-years, and post-bronchodilator forced expiratory volume in 1 s/forced vital capacity < 0.7. Patients with ACO were divided into four groups according to smoking history (threshold: 20 pack-years) and blood eosinophil count (threshold: 300 cells/μL).Results: The prevalence of ACO significantly differed between the COPD and severe asthma cohorts (19.8% [365/1839] vs. 12.5% [104/832], respectively, P < 0.001). The numbers of patients in each group were as follows: Group A (smoking 10–20 pack-years and blood eosinophil count ≥ 300 cells/μL), 42 (9.1%); Group B (smoking 10–20 pack-years and eosinophil count < 300 cells/μL), 17 (3.7%); Group C (smoking ≥ 20 pack-years and eosinophil count ≥ 300 cells/μL), 341 (73.8%); and Group D (smoking ≥ 20 pack-years and eosinophil count < 300 cells/μL), 62 (13.4%). Age, sex, BDR, comorbidities, and medications significantly differed among the four groups.Conclusion: The prevalence of ACO differed between COPD and severe asthma cohorts. ACO patients can be classified into four phenotype groups, such that each phenotype exhibits distinct characteristics.

scholarly journals The association between eosinophilic exacerbation and eosinophilic levels in stable COPD

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hye Seon Kang ◽  
Sung Kyoung Kim ◽  
Yong Hyun Kim ◽  
Jin Woo Kim ◽  
Sang Haak Lee ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Blood Eosinophil Count ◽  
Acute Exacerbations ◽  
Retrospective Multicenter Study ◽  
Predict Treatment Response ◽  
Eosinophil Counts

Abstract Background Blood eosinophil count may predict treatment response in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbations (AE). However, the ability and thresholds of blood eosinophil counts in stable status to predict eosinophilic AECOPD have not been completely investigated. Methods This was a retrospective multicenter study performed January 2010 to December 2014. COPD subjects hospitalized with exacerbations, were included. Blood samples were obtained at the time of AE and stable disease at outpatient clinic before or after admission. We identified a blood eosinophil count cut-off point at stable COPD, either taken as a percentage or as absolute value, for identification of eosinophilic exacerbation. Results There was significant positive correlation of eosinophil counts between stable COPD and AECOPD. The best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation based on blood eosinophil count ≥ 2% was 300 cells/µL (area under the ROC curve [AUC] 0.614, P = 0.001, 39% sensitivity, 83.8% specificity). When the eosinophilic COPD exacerbation was based on blood eosinophil count ≥ 300 cells/µL, the best cut-off value of blood eosinophil count in stable status for the prediction of eosinophilic COPD exacerbation was also 300 cells/uL (AUC 0.634, P = 0.046, 45.8% sensitivity, 80.9% specificity). Conclusions We demonstrated association between blood eosinophil counts at stable COPD and those with AECOPD. The thresholds of blood counts at stable COPD to predict eosinophilic exacerbations was 300 cells/µL. Further and prospective studies in other populations should validate our results.

scholarly journals Blood eosinophil count and risk of pneumonia hospitalisations in individuals with COPD

2018 ◽  
Vol 51 (5) ◽  
pp. 1800120 ◽  
Author(s):  
Signe Vedel-Krogh ◽  
Børge G. Nordestgaard ◽  
Peter Lange ◽  
Jørgen Vestbo ◽  
Sune F. Nielsen
Keyword(s):  
High Risk ◽  
General Population ◽  
Eosinophil Count ◽  
Inhaled Corticosteroids ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Exacerbation Rate ◽  
General Population Study ◽  
Blood Eosinophil Count ◽  
Eosinophil Counts

Blood eosinophil count in chronic obstructive pulmonary disease (COPD) is associated with higher exacerbation rate and favourable response to corticosteroids; however, frequent exacerbations and use of inhaled corticosteroids could elevate pneumonia risk. We tested the hypothesis that high blood eosinophil counts are associated with high risk of pneumonia in individuals with severe COPD from the general population.We included 7180 individuals with COPD from the Copenhagen General Population Study, including 643 with forced expiratory volume in 1 s (FEV1) <50% predicted between 2003 and 2011. All primary discharge diagnoses of pneumonia during follow-up were recorded.Among individuals with COPD and FEV1<50% pred, the multivariable adjusted incidence rate ratio was 2.17 (95% CI 1.31–3.58) for pneumonia comparing individuals with blood eosinophil counts ≥0.34×109 cells·L−1versus<0.34×109 cells·L−1. In individuals with clinical COPD, defined by recent exacerbation, ≥10 pack-years of smoking and FEV1<70% pred, the corresponding risk was 4.52 (2.11–9.72). Risk of pneumonia did not differ by blood eosinophil count in individuals with COPD and FEV1≥50% pred.In individuals with COPD and FEV1<50% pred, blood eosinophil count ≥0.34×109 cells·L−1was associated with high risk of hospitalisation due to pneumonia.

scholarly journals Th-2 signature in chronic airway diseases: towards the extinction of asthma−COPD overlap syndrome?

2017 ◽  
Vol 49 (5) ◽  
pp. 1602397 ◽  
Author(s):  
Borja G. Cosío ◽  
Luis Pérez de Llano ◽  
Antolin Lopez Viña ◽  
Alfons Torrego ◽  
Jose Luis Lopez-Campos ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Airway Disease ◽  
Obstructive Airway Disease ◽  
Chronic Obstructive ◽  
Blood Eosinophil ◽  
Chronic Obstructive Airway Disease ◽  
Cross Sectional ◽  
Exacerbation Rate ◽  
Blood Eosinophil Count ◽  
Inflammatory Pattern

We aimed to describe the differences and similarities between patients with chronic obstructive airway disease classified on the basis of classical diagnostic labels (asthma, chronic obstructive pulmonary disease (COPD), or asthma–COPD overlap (ACOS)) or according to the underlying inflammatory pattern (Th-2 signature, either Th-2-high or Th-2-low).We performed a cross-sectional study of patients aged ≥40 years and with a post-bronchodilator forced expiratory volume in 1 s to forced vital capacity ratio ≤0.7 with a previous diagnosis of asthma (non-smoking asthmatics (NSA)), COPD or ACOS, the latter including both smoking asthmatics (SA) and patients with eosinophilic COPD (COPD-e). Clinical, functional and inflammatory parameters (blood eosinophil count, IgE and exhaled nitric oxide fraction (FeNO)) were compared between groups. Th-2 signature was defined by a blood eosinophil count ≥300 cells·μL−1 and/or a sputum eosinophil count ≥3%.Overall, 292 patients were included in the study: 89 with COPD, 94 NSA and 109 with ACOS (44 SA and 65 with COPD-e). No differences in symptoms or exacerbation rate were found between the three groups. With regards the underlying inflammatory pattern, 94 patients (32.2%) were characterised as Th-2-high and 198 (67.8%) as Th-2-low. The Th-2 signature was found in 49% of NSA, 3.3% of patients with COPD, 30% of SA and 49.3% of patients with COPD-e. This classification yielded significant differences in demographic, functional and inflammatory characteristics.We conclude that a classification based upon the inflammatory profile, irrespective of the taxonomy, provides a more clear distinction of patients with chronic obstructive airway disease.

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