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Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD

In patients with COPD, there is controversy regarding the association of blood eosinophil (Eos) levels with 1) exacerbation frequency and 2) the effect of inhaled corticosteroids for prevention of exacerbations. To determine whether Eos define subgroups of patients exhibiting attributes of COPD clin...

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Autores principales: Zysman, Maeva, Deslee, Gaëtan, Caillaud, Denis, Chanez, Pascal, Escamilla, Roger, Court-Fortune, Isabelle, Nesme-Meyer, Pascale, Perez, Thierry, Paillasseur, Jean-Louis, Pinet, Christophe, Jebrak, Gilles, Roche, Nicolas, Burgel, Pierre-Régis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490470/
https://www.ncbi.nlm.nih.gov/pubmed/28694695
http://dx.doi.org/10.2147/COPD.S129787
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author Zysman, Maeva
Deslee, Gaëtan
Caillaud, Denis
Chanez, Pascal
Escamilla, Roger
Court-Fortune, Isabelle
Nesme-Meyer, Pascale
Perez, Thierry
Paillasseur, Jean-Louis
Pinet, Christophe
Jebrak, Gilles
Roche, Nicolas
Burgel, Pierre-Régis
author_facet Zysman, Maeva
Deslee, Gaëtan
Caillaud, Denis
Chanez, Pascal
Escamilla, Roger
Court-Fortune, Isabelle
Nesme-Meyer, Pascale
Perez, Thierry
Paillasseur, Jean-Louis
Pinet, Christophe
Jebrak, Gilles
Roche, Nicolas
Burgel, Pierre-Régis
author_sort Zysman, Maeva
collection PubMed
description In patients with COPD, there is controversy regarding the association of blood eosinophil (Eos) levels with 1) exacerbation frequency and 2) the effect of inhaled corticosteroids for prevention of exacerbations. To determine whether Eos define subgroups of patients exhibiting attributes of COPD clinical phenotypes, we compared clinical features and mortality rates in COPD patients from the Initiatives BPCO French cohort categorized using different thresholds of blood Eos levels. The following data were collected at inclusion: medical and smoking history, occupational exposures, dyspnea, cough and sputum production, exacerbations in the previous year, history of allergy and asthma, nasal symptoms, body mass index, St George Respiratory Questionnaire (SGRQ) total score, post-bronchodilator spirometry, comorbidities, and medications. Three-year survival between groups was compared using Kaplan–Meier analysis. Three sets of analyses were performed to compare patients with ≥2% versus <2%, ≥3% versus <3%, and ≥4% versus <4% Eos. Eos was available in 458 patients (mean age: 62 years, 72% male, mean forced expiratory volume in 1 second: 51% pred), including 235 patients with Eos ≥2% (49%), 149 with Eos ≥3% (33%), and 90 with Eos ≥4% (20%). For all cutoffs, there was no difference between Eos+ and Eos− groups in univariate analyses except for diabetes and SGRQ score (more frequent and more impaired, respectively, in lower Eos categories). In particular, there was no difference in exacerbation rate, history of asthma, or three-year survival. In conclusion, regardless of the cutoff, Eos+ COPD patients exhibited no specific characteristic in terms of symptoms, lung function, exacerbation rate, and prognosis. These findings suggest that the association of higher Eos with exacerbations reported in previous studies could be population specific, which does not support generalizing the use of Eos as a biomarker for COPD phenotyping.
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spelling pubmed-54904702017-07-10 Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD Zysman, Maeva Deslee, Gaëtan Caillaud, Denis Chanez, Pascal Escamilla, Roger Court-Fortune, Isabelle Nesme-Meyer, Pascale Perez, Thierry Paillasseur, Jean-Louis Pinet, Christophe Jebrak, Gilles Roche, Nicolas Burgel, Pierre-Régis Int J Chron Obstruct Pulmon Dis Original Research In patients with COPD, there is controversy regarding the association of blood eosinophil (Eos) levels with 1) exacerbation frequency and 2) the effect of inhaled corticosteroids for prevention of exacerbations. To determine whether Eos define subgroups of patients exhibiting attributes of COPD clinical phenotypes, we compared clinical features and mortality rates in COPD patients from the Initiatives BPCO French cohort categorized using different thresholds of blood Eos levels. The following data were collected at inclusion: medical and smoking history, occupational exposures, dyspnea, cough and sputum production, exacerbations in the previous year, history of allergy and asthma, nasal symptoms, body mass index, St George Respiratory Questionnaire (SGRQ) total score, post-bronchodilator spirometry, comorbidities, and medications. Three-year survival between groups was compared using Kaplan–Meier analysis. Three sets of analyses were performed to compare patients with ≥2% versus <2%, ≥3% versus <3%, and ≥4% versus <4% Eos. Eos was available in 458 patients (mean age: 62 years, 72% male, mean forced expiratory volume in 1 second: 51% pred), including 235 patients with Eos ≥2% (49%), 149 with Eos ≥3% (33%), and 90 with Eos ≥4% (20%). For all cutoffs, there was no difference between Eos+ and Eos− groups in univariate analyses except for diabetes and SGRQ score (more frequent and more impaired, respectively, in lower Eos categories). In particular, there was no difference in exacerbation rate, history of asthma, or three-year survival. In conclusion, regardless of the cutoff, Eos+ COPD patients exhibited no specific characteristic in terms of symptoms, lung function, exacerbation rate, and prognosis. These findings suggest that the association of higher Eos with exacerbations reported in previous studies could be population specific, which does not support generalizing the use of Eos as a biomarker for COPD phenotyping. Dove Medical Press 2017-06-20 /pmc/articles/PMC5490470/ /pubmed/28694695 http://dx.doi.org/10.2147/COPD.S129787 Text en © 2017 Zysman et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Zysman, Maeva
Deslee, Gaëtan
Caillaud, Denis
Chanez, Pascal
Escamilla, Roger
Court-Fortune, Isabelle
Nesme-Meyer, Pascale
Perez, Thierry
Paillasseur, Jean-Louis
Pinet, Christophe
Jebrak, Gilles
Roche, Nicolas
Burgel, Pierre-Régis
Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD
title Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD
title_full Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD
title_fullStr Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD
title_full_unstemmed Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD
title_short Relationship between blood eosinophils, clinical characteristics, and mortality in patients with COPD
title_sort relationship between blood eosinophils, clinical characteristics, and mortality in patients with copd
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490470/
https://www.ncbi.nlm.nih.gov/pubmed/28694695
http://dx.doi.org/10.2147/COPD.S129787
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