RT Journal Article
SR Electronic
T1 Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1700853
DO 10.1183/13993003.00853-2017
VO 50
IS 4
A1 Viktoriya L. Kim
A1 Ngaire A. Coombs
A1 Karl J. Staples
A1 Kristoffer K. Ostridge
A1 Nicholas P. Williams
A1 Stephen A. Wootton
A1 Jeanne-Marie Devaster
A1 Emmanuel Aris
A1 Stuart C. Clarke
A1 Andrew C. Tuck
A1 Simon C. Bourne
A1 Tom M.A. Wilkinson
A1 ,
YR 2017
UL http://erj.ersjournals.com/content/50/4/1700853.abstract
AB Eosinophilic inflammation in chronic obstructive pulmonary disease (COPD) predicts response to treatment, especially corticosteroids. We studied the nature of eosinophilic inflammation in COPD prospectively to examine the stability of this phenotype and its dynamics across exacerbations, and its associations with clinical phenotype, exacerbations and infection.127 patients aged 40–85 years with moderate to very severe COPD underwent repeated blood and sputum sampling at stable visits and within 72 h of exacerbation for 1 year.Blood eosinophils ≥2% was prevalent at baseline, and predicted both predominantly raised stable-state eosinophils across the year (area under the curve 0.841, 95% CI 0.755–0.928) and increased risk of eosinophilic inflammation at exacerbation (OR 9.16; p<0.001). Eosinophils ≥2% at exacerbation and eosinophil predominance at stable visits were associated with a lower risk of bacterial presence at exacerbation (OR 0.49; p=0.049 and OR 0.25; p=0.065, respectively). Bacterial infection at exacerbation was highly seasonal (winter versus summer OR 4.74; p=0.011) in predominantly eosinophilic patients.Eosinophilic inflammation is a common and stable phenotype in COPD. Blood eosinophil counts in the stable state can predict the nature of inflammation at future exacerbations, which when combined with an understanding of seasonal variation provides the basis for the development of new treatment paradigms for this important condition.Blood eosinophil levels in COPD predict the nature of inflammation at future exacerbations and may guide therapy http://ow.ly/W10o30dNQiq