RT Journal Article
SR Electronic
T1 Blood eosinophil count in the general population: typical values and potential confounders
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1901874
DO 10.1183/13993003.01874-2019
A1 S. Hartl
A1 M.K. Breyer
A1 O.C. Burghuber
A1 A. Ofenheimer
A1 A. Schrott
A1 M.H. Urban
A1 A. Agusti
A1 M. Studnicka
A1 E.F.M. Wouters
A1 R. Breyer-Kohansal
YR 2020
UL http://erj.ersjournals.com/content/early/2020/01/24/13993003.01874-2019.abstract
AB There is growing interest in blood eosinophil counts in the management of chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease [COPD]). Despite this, typical blood eosinophil levels in the general population, and the impact of potential confounders on these levels have not been clearly defined.We measured blood eosinophil counts in a random sample of 11 042 subjects recruited from the general population in Austria. We then: (1) identified factors associated with high blood eosinophil counts (>75th percentile); and, (2) excluded subjects with these factors to estimate median blood eosinophil counts in a “healthy” sub-population (n=3641).We found that: (1) in the entire cohort, age ≤18 years (odds ratio [OR] 2.41), asthma (OR 2.05), current smoking (OR 1.72), positive skin prick test (OR 1.64), COPD (OR 1.56), metabolic syndrome (OR 1.41), male sex (OR 1.36) and obesity (OR 1.16) were significantly (p<0.05) associated with high blood eosinophil counts (binary multivariable logistic regression analysis); and had an additive effect; (2) after excluding these factors, in those older than 18 years, blood eosinophil counts were higher in males than in females (median 120 [5%–95% CI: 30–330] versus 100 [30–310] cells·µL−1, respectively) and did not change with age.Median blood eosinophil counts in adults are considerably lower than those currently regarded as normal, do not change with age beyond puberty, but are significantly influenced by a variety of factors which have an additive effect. These observations will contribute to the interpretation of blood eosinophil levels in clinical practice.FootnotesThis 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: S. Hartl has received unrestricted research grants for the Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology and is on advisory boards for GSK, Boehringer Ingelheim, Novartis, Menarini, Chiesi, AstraZeneca, MSD, Roche, Abbvie, Takeda and TEVA for respiratory oncology and COPD.Conflict of interest: M-K. Breyer reports unrestricted grants for the LEAD study from GlaxoSmithKline, Novartis Pharma, AstraZeneca, Chiesi Pharma, Menarini Pharma, TEVA Ratiopharm, MSD, Air Liquide Health Care, Pfizer Corporation, Boehringer Ingelheim and Mundipharma.Conflict of interest: O.C. Burghuber reports grants from Boehringer Ingelheim, GSK, AstraZeneca, Menarini, Teva, Pfizer, Chiesi, Federal State Goverment Dept of Health and Novartis, non-financial support from AirLiquid and Municipial Dept of Health in Vienna, during the conduct of the study; personal fees for advisory board work and lectures from Boehringer Ingelheim, AstraZeneca, Chiesi, MSD, Menarini and Roche, personal fees for advisory board work from GSK, outside the submitted work.Conflict of interest: A. Ofenheimer has nothing to disclose.Conflict of interest: A. Schrott has nothing to disclose.Conflict of interest: M.H. Urban reports grants from Nycomed Pharma, during the conduct of the study; personal fees for lectures and advisory board work from AstraZeneca and Boehringer Ingelheim, outside the submitted work.Conflict of interest: A. Agusti reports personal fees from AstraZeneca, Chiesi and Nuvaira, grants and personal fees from Menarini and GSK, outside the submitted work.Conflict of interest: M. Studnicka reports personal fees for consultancy from Chiesi, AstraZeneca, Novartis, Boehringer and Almirall, and personal fees for lectures from GSK, AstraZeneca, Almirall, Novartis and Boehringer, outside the submitted work.Conflict of interest: E.F.M. Wouters reports personal fees for advisory board work from Nycomed and Boehringer, grants from AstraZeneca and GSK, personal fees for lectures from AstraZeneca, Novartis, GSK and Chiesi, outside the submitted work.Conflict of interest: R. Breyer-Kohansal reports personal fees for presentations and/or participations for AstraZeneca, Boehringer Ingelheim, Chiesi and Novartis outside the submitted work.