Outcomes of Peripheral Blood Eosinophilia in Hospitalized Exacerbations of COPD

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Samar El Sharkawy ◽  
Riham Hazem Raafat ◽  
Reem Osama Mohamed Ahmed Qassem

Abstract Background The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines define COPD as a disease state characterized by airflow limitation that is not fully reversible, is usually progressive, and is associated with an abnormal inflammatory response of the lungs to inhaled noxious particles or gases. Objective To identify outcomes of patients with eosinophilic COPD exacerbations requiring hospital admission. Patients and Methods This study is a prospective cohort study that was conducted on two groups of total 60 patients recruited from Ain Shams University hospitals between October 2019 and July 2020. Group 1: Eosinophilic COPD exacerbation if the peripheral blood eosinophil on admission is ≥ 200 cells/µL and/or ≥2% of the total leukocyte count Group 2: Non-eosinophilic COPD exacerbation if the peripheral blood eosinophil on admission is < 200 cells/µL and/or < 2% of the total leukocyte count. Results There was significant high diagnostic performance in predicting readmission at 6-month among eosinophilic group. Eosinophils count, percent (%) and NLR cutoff points had high characteristics (highest in NLR ≥3.1 at discharge) in predicting readmission at 6-month among eosinophilic group. Diagnostic performance of Eosinophils count, percent (%) and NLR were assessed. Eosinophils count, percent (%) and NLR had significant high diagnostic performance in predicting readmission at 6-month among eosinophilic group. Eosinophils count, % and NLR cutoff points had high characteristics (highest in NLR ≥2.1 at discharge) in predicting readmission at 6month among non-eosinophilic group. Conclusion Eosinophils can be used as a prognostic marker in non-infective COPD exacerbations. Validity of eosinophil count and percent as a prognostic parameter in COPD exacerbation can be increased by combining with other parameters for example NLR.

2017 ◽  
Vol 139 (4) ◽  
pp. 1388-1390.e4 ◽  
Author(s):  
Michael R. Goldberg ◽  
Arnon Elizur ◽  
Liat Nachshon ◽  
Michael Y. Appel ◽  
Michael B. Levy ◽  
...  

2021 ◽  
Vol 15 (11) ◽  
pp. 2926-2927
Author(s):  
Zertaj Kashif ◽  
Tooba Fateen ◽  
H. Tufail Chaudhary ◽  
Sehar S. Ali ◽  
M. Bilal Pasha ◽  
...  

Aim: To observe the association of peripheral blood eosinophil percentage in patients with allergic nasal polyps. Design: Descriptive cross-sectional study Place and duration: Pathology Department of Bakhtawar Amin Medical & Dental Hospital, Multan from September 2020 to August 2021. Methodology: Blood samples of all the cases operated for nasal polyps in Bakhtawar Amin Trust Institute are drawn before surgery to look for eosinophils. Family and past history of allergy is recorded. Histopathology of all the operated specimen of nasal polyps is done and sample for eosinophil count is collected again in cases that proved to be allergic nasal polyps on microscopic examination to look for any alteration in eosinophil percentage in blood on excision of polyps. Results: Twenty nine out of forty (72.5) percent of patients with allergic nasal polyps reveal increase in peripheral blood eosinophil percentage that returned to normal in 26(65%) patient on excision of nasal polyps. Conclusion: The study disclosed a notable link between allergic nasal polyps and peripheral blood eosinophil percentage and this association is further enhanced by the fact that the blood eosinophil count returned to normal on removal of nasal polyps. Keywords: Allergic nasal polyps, peripheral blood eosinophilia, eosinophil count, atopy


2021 ◽  
Vol 42 (3) ◽  
pp. 228-234
Author(s):  
Bo Zhao ◽  
Haiming Zheng ◽  
Xiaopan Li ◽  
Rui Zheng

Objective: This study aimed to explore the usefulness of the peripheral blood eosinophil count (PBEC) in assessing the level of fractional exhaled nitric oxide (FeNO) and predicting bronchodilation test results. Methods: We retrospectively analyzed the data of 384 outpatients who underwent FeNO measurement at our Department of Respiratory and Critical Care Medicine from March to June 2019. The FeNO level was compared among different PBECs to explore the association among them. Furthermore, the sensitivity and specificity of PBECs in predicting bronchodilation test results were assessed by using receiver operating characteristic (ROC) curve analysis. Results: There was a moderate correlation between PBECs and FeNO levels (r = 0.414; p < 0.05). In the subjects with PBECs ≥ 0.3 × 109/L, the median FeNO level was 39 ppb (interquartile range, 22.5‐65.5 ppb), significantly higher than in the subjects with PBECs < 0.3 × 109/L. The area under the ROC curve was 0.707 (p < 0.05). The maximum Youden index (0.348) was at PBECs = 0.205 × 109/L, which achieved sensitivity and specificity of 63% and 71.8%, respectively. Conclusion: PBECs ≥ 0.3 × 109/L can predict a positive bronchodilation test result and a high FeNO level, with a probability of 50% in the subjects with chronic cough and shortness of breath; in the absence of corresponding symptoms and a low PBEC, the predictive value was small. For hospitals not able to conduct FeNO measurements, for outpatients with poor economic conditions, and for patients with confirmed or suspected novel coronavirus disease 2019, the PBEC, in conjunction with a patient's clinical symptoms, can improve the diagnostic accuracy of allergic asthma and assessment of airway inflammation while reducing the risk of infection.


Medicina ◽  
2007 ◽  
Vol 43 (1) ◽  
pp. 60 ◽  
Author(s):  
Vilma Jurkštienė ◽  
Anatolijus Kondrotas ◽  
Egidijus Kėvelaitis

The aim of the study was to investigate the immunostimulatory properties of bigroot geranium. Material and methods. Possible nonspecific characteristics of bigroot geranium were evaluated by the total leukocyte count in the peripheral blood, and qualitative changes of blood were assessed using Shilling’s formula by evaluating changes in lymphocyte counts. In addition, we also studied changes in the counts of Tcell precursors in the thymus and B lymphocytes in the spleen. Ethanol extract of the leaves of bigroot geranium was produced at the Department of Food Technology, Kaunas University of Technology. Studies were performed on mice Bl 57 (n=21). The control group (n=7) received distilled water at a dose of 1 mL/day. The second and third groups received 1% and 10% extract of bigroot geranium, respectively, as a food supplement. Changes in cell counts were investigated after 4 weeks following the initiation of the trial. Results. After a 4-week administration of 1% extract of bigroot geranium (1 mL/day) (mice group, n=7), leukocyte count in the peripheral blood increased to 6.1×109 cells/L, and lymphocyte count – to 70%, but changes were not statistically significant. The other case group of mice (n=7) received 10% extract of bigroot geranium for 4 weeks at a dose of 1 mL/day. In this group, leukocyte count in the peripheral blood increased statistically significantly from 4.4×109 cells/L to 7.2×109 cells/L (p<0.01), and lymphocyte percentage – from 52% to 80% (p<0.001), as compared to control. Thymocyte (T lymphocytes) counts in thymus and splenocyte (B lymphocytes) counts in the spleen showed a tendency to increase after the administration of 1% and 10% extracts. After a 4-week administration of 1% extract of bigroot geranium, thymocyte and splenocyte counts increased from 0.342×106 cells to 0.372×106 cells per mg of tissue and from 0.395×106 cells to 0.405×106 cells per mg of tissue, respectively, as compared to control group (p>0.1). After the administration of 10% extract of bigroot geranium, thymocyte count increased to 0.488×106 cells per mg of tissue (p<0.01), and splenocyte count – to 0.504×106 cells per mg of tissue (p<0.01). Conclusion. The extracts of the leaves of bigroot geranium increased leukocyte count and lymphocyte percentage in the peripheral blood, and after a 4-week administration of 10% extract of bigroot geranium, a statistically significant increase in the counts of T lymphocytes (in the thymus) and B lymphocytes (in the spleen) was observed. The immunostimulatory effect depends on the dose of the extract.


Allergy ◽  
2020 ◽  
Author(s):  
Guogang Xie ◽  
Fengming Ding ◽  
Lei Han ◽  
Dongning Yin ◽  
Hongzhou Lu ◽  
...  

2013 ◽  
Vol 8 ◽  
pp. BMI.S12537 ◽  
Author(s):  
Go Kato ◽  
Koichiro Takahashi ◽  
Kenji Izuhara ◽  
Kazutoshi Komiya ◽  
Shinya Kimura ◽  
...  

Evaluation of airway inflammation is important in achieving adequate dosing of inhaled corticosteroids (ICS) for treating bronchial asthma. However, there is no evaluation tool that can be used in clinical settings. We examined biomarkers that can precisely reflect airway inflammation when ICS are decreased in stable asthmatic patients. This was a 12-week, single-arm, open-label clinical study performed at a single university hospital. Twenty-five patients (6 male and 19 female) with stable asthma were included in this study. We investigated whether the levels of nitrite and nitrate in exhaled breath condensate (EBC) increase after ICS reduction. We also investigated whether blood eosinophils, serum immunoglobulin E (IgE), high-sensitivity C reactive protein (hs-CRP), interleukin (IL)-13, IL-17, and periostin are different before and after ICS reduction. Peak expiratory flow (PEF), pulmonary function tests, asthma control test (ACT), and asthma quality of life questionnaire (AQLQ) were also examined. We considered an unscheduled hospital visit due to asthmatic symptoms and decline in average PEF over one week by more than 10% to indicate disease instability, and compared patients with stable and unstable disease for analysis. Unstable status was detected in 5 patients. Age, sex, asthma duration, ACT and AQLQ scores, and the level of serum IgE did not differ between stable and unstable groups. In the unstable group, the total concentration of nitrite and nitrate at the last visit was 9.84 (6.65–11.24) μM. Surprisingly, this was similar to the concentration at the first visit (5.58 (2.94–17.29) μM). Serum periostin before ICS reduction (141.9 [107.7–147.7] pg/mL) was higher in the unstable group than in the stable group (91.5 [78.75–103.5] pg/mL). The unstable group had a higher peripheral blood eosinophil count and wider diurnal variation of PEF at the first visit compared to the stable group. Higher eosinophils in peripheral blood and wider diurnal variation of PEF were predictive markers for unstable disease after ICS reduction. Serum periostin is another candidate for the predictive marker.


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