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Circulating eosinophil levels do not predict severe exacerbations in COPD: a retrospective study.

Yochai Adir¹, Omar Hakrush¹, Michal Shteinberg¹

¹Pulmonary Division, Lady Davis Carmel Medical Center, Faculty of Medicine, The Technion Institute of Technology, Haifa, Israel.

ERJ Open Research

|August 8, 2018

Summary

Elevated eosinophils in COPD patients do not predict severe exacerbations or treatment response. Most patients have high eosinophil levels, but this doesn

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Identification and Characterization of Immunogenic RNA Species in HDM Allergens that Modulate Eosinophilic Lung Inflammation

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Published on: May 30, 2020

Area of Science:

Pulmonary Medicine
Clinical Immunology

Background:

The role of eosinophils in chronic obstructive pulmonary disease (COPD) exacerbations is debated.
Predicting severe exacerbations of COPD (ECOPD) and treatment response remains a clinical challenge.

Purpose of the Study:

To evaluate the prevalence of elevated eosinophils in COPD patients.
To determine the relationship between eosinophil levels and severe ECOPD requiring hospitalization.
To assess the association with recurrent exacerbations and inhaled corticosteroid response.

Main Methods:

Retrospective chart review of 992 COPD patients (318 ECOPD, 674 controls).
Analysis of circulating eosinophil counts during clinical stability and hospitalization.
Correlation of eosinophil levels with clinical data, airflow limitation, and recurrent exacerbations.

Main Results:

Prevalence of eosinophils ≥2% was high and similar in ECOPD patients (72%) and controls (71%).
Eosinophil levels (≥2%, ≥4%, or ≥300 cells·μL⁻¹) did not significantly associate with recurrent severe exacerbations.
Severity of airflow limitation correlated with exacerbations, but inhaled corticosteroid treatment did not.

Conclusions:

The majority of COPD patients exhibit elevated circulating eosinophils (>2%).
Circulating eosinophil levels do not reliably predict the risk of severe ECOPD or response to inhaled corticosteroids.
Airflow limitation severity is a more significant factor for recurrent exacerbations than eosinophil counts.