Abstract
Eosinophilic inflammation and airway remodelling are characteristic features of asthma, but the association between them is unclear. We assessed associations between blood eosinophils and lung function decline in a population-based cohort of young adults.
We used linear mixed models to analyse associations between blood eosinophils and spirometry at 21, 26, 32, and 38 years adjusting for sex, smoking, asthma, and spirometry at age 18. We further analysed associations between mean eosinophil counts and changes in spirometry from ages 21 to 38 years.
Higher eosinophils were associated with lower FEV1/FVC ratios and lower percent-predicted FEV1 values for both pre- and post-bronchodilator spirometry (all p values≤0.048). Although eosinophil counts were higher in participants with asthma, the associations between eosinophils and spirometry were similar among participants without asthma or wheeze. Participants with mean eosinophil counts >0.4×109/L between ages 21 and 38 had greater declines in FEV1/FVC ratios (difference 1.8%; 95% CI 0.7, 2.9; p=0.001) and FEV1 values (difference 3.4%predicted; 95% CI 1.5, 5.4); p=0.001) than those with lower counts.
Blood eosinophils are associated with airflow obstruction and enhanced decline in lung function independently of asthma and smoking. Eosinophilia is a risk factor for airflow obstruction even in those without symptoms.
Abstract
Blood eosinophils are associated with lung function decline even in people without asthma or wheeze
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Hancox reports grants from Health Research Council, other from Duke University, during the conduct of the study; other from Astra Zeneca, other from Menarini, outside the submitted work.
Conflict of interest: Dr. Pavord reports grants from GSK, during the conduct of the study; other from AstraZeneca, Boehringer Ingelheim, Aerocrine, Almirall, Novartis and GSK, other from Almirall, AstraZeneca, Boehringer Ingelheim, Dey Pharma, GSK, MSD, Schering-Plough, Novartis, Napp Pharmaceuticals and RespiVert, other from AstraZeneca, Boehringer Ingelheim, GSK and Napp Pharmaceuticals, outside the submitted work.
Conflict of interest: Dr. Sears reports other from Astra Zeneca, outside the submitted work.
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