Blood Eosinophil Counts in Patients with Marked FEV1 Reversibility and Fixed Airflow Obstruction

2019 ◽  
Author(s):  
S. Riley ◽  
R. Al-Lehebi ◽  
S. Gurupatham ◽  
E. Grbac ◽  
M.B. Stanbrook
Keyword(s):  
Airflow Obstruction ◽  
Blood Eosinophil ◽  
Fixed Airflow Obstruction ◽  
Eosinophil Counts

scholarly journals Prevalence and clinical implications of bronchiectasis in patients with overlapping asthma and chronic rhinosinusitis: a single-center prospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haiyan Sheng ◽  
Xiujuan Yao ◽  
Xiangdong Wang ◽  
Yuhong Wang ◽  
Xiaofang Liu ◽  
...  
Keyword(s):  
Prospective Study ◽  
Chronic Rhinosinusitis ◽  
Peripheral Blood ◽  
Scoring System ◽  
Severe Disease ◽  
Airflow Obstruction ◽  
Blood Eosinophil ◽  
Severe Exacerbation ◽  
Peripheral Blood Eosinophil ◽  
Eosinophil Counts

Abstract Background As a typical “united airway” disease, asthma-chronic rhinosinusitis (CRS) overlap has recently drawn more attention. Bronchiectasis is a heterogeneous disease related to a variety of diseases. Whether bronchiectasis exists and correlates with asthma-CRS patients has not been fully elucidated. The purpose of the study was to explore the presence and characteristics of bronchiectasis in patients with overlapping asthma and CRS. Methods This report describes a prospective study with consecutive asthma-CRS patients. The diagnosis and severity of bronchiectasis were obtained by thorax high-resolution computed tomography (HRCT), the Smith radiology scale and the Bhalla scoring system. CRS severity was evaluated by paranasal sinus CT and the Lund-Mackay (LM) scoring system. The correlations between bronchiectasis and clinical data, fraction of exhaled nitric oxide, peripheral blood eosinophil counts and lung function were analyzed. Results Seventy-two (40.91%) of 176 asthma-CRS patients were diagnosed with bronchiectasis. Asthma-CRS patients with overlapping bronchiectasis had a higher incidence rate of nasal polyps (NPs) (P = 0.004), higher LM scores (P = 0.044), higher proportion of ≥ 1 severe exacerbation of asthma in the last 12 months (P = 0.003), lower postbronchodilator forced expiratory volume in one second (FEV1) % predicted (P = 0.006), and elevated peripheral blood eosinophil counts (P = 0.022). Smith and Bhalla scores were shown to correlate positively with NPs and negatively with FEV1% predicted and body mass index. Cutoff values of FEV1% predicted ≤ 71.40%, peripheral blood eosinophil counts > 0.60 × 109/L, presence of NPs, and ≥ 1 severe exacerbation of asthma in the last 12 months were shown to differentiate bronchiectasis in asthma-CRS patients. Conclusions Bronchiectasis commonly overlaps in asthma-CRS patients. The coexistence of bronchiectasis predicts a more severe disease subset in terms of asthma and CRS. We suggest that asthma-CRS patients with NPs, severe airflow obstruction, eosinophilic inflammation, and poor asthma control should receive HRCT for the early diagnosis of bronchiectasis.

scholarly journals Inflammatory patterns in fixed airflow obstruction are dependent on the presence of asthma

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243109
Author(s):  
Ida Mogensen ◽  
Tiago Jacinto ◽  
Kjell Alving ◽  
João A. Fonseca ◽  
Christer Janson ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Odds Ratio ◽  
Airflow Obstruction ◽  
Exhaled Nitric Oxide ◽  
Smoking History ◽  
Blood Eosinophil ◽  
Elevated Blood ◽  
Blood Neutrophil ◽  
Fixed Airflow Obstruction ◽  
Asthma Group

Rationale Fixed airflow obstruction (FAO) can complicate asthma. Inflammation is a proposed underlying mechanism. Objective Our aim in this cross-sectional investigation was to evaluate the blood leucocyte pattern and level of exhaled nitric oxide in asthmatics and non-asthmatics with or without FAO. Methods A total of 11,579 individuals aged ≥20 years from the US National Health and Nutrition Examination Survey were included. They were grouped as: controls without asthma and FAO (n = 9,935), asthmatics without FAO (n = 674), asthmatics with FAO (n = 180) and non-asthmatics with FAO (n = 790). FAO was defined as post-bronchodilator FEV1/FVC < lower limit of normal. Exhaled nitric oxide ≥ 25ppb, blood eosinophil levels ≥300 cells/μL, and blood neutrophil levels ≥5100 cells/μL were defined as elevated. Stratified analyses for smoking and smoking history were performed. Results Elevated blood eosinophil levels were more common in all groups compared to the controls, with the highest prevalence in the group with asthma and fixed airflow obstruction (p<0.01). In a multiple logistic regression model adjusted for potential confounders including smoking, the asthma groups had significantly higher odds ratios for elevated B-Eos levels compared to the control group (odds ratio 1.4, (confidence interval: 1.1–1.7) for the asthma group without fixed airflow obstruction and 2.5 (1.4–4.2) for the asthma group with fixed airflow obstruction). The group with fixed airflow obstruction without asthma had higher odds ratio for elevated blood neutrophil levels compared to the controls: 1.4 (1.1–1.8). Smoking and a history of smoking were associated to elevated B-Neu levels. Conclusion Fixed airflow obstruction in asthma was associated with elevated blood eosinophil levels, whereas fixed airflow obstruction without asthma was associated with elevated blood neutrophil levels.

scholarly journals EPOC: Enfoque personalizado para el tratamiento según la guía GOLD 2021

2021 ◽  
pp. 1-2
Author(s):  
Moisés Acuña-Kaldman
Keyword(s):  
Airflow Obstruction ◽  
Dry Powder Inhaler ◽  
Phase Iii ◽  
Controlled Study ◽  
Blood Eosinophil ◽  
Severe Exacerbation ◽  
Airway Reversibility ◽  
Eosinophil Counts ◽  
Severe Copd ◽  
Formoterol Fumarate

<b>Background:</b> In the Phase III KRONOS study, triple therapy with budesonide/glycopyrronium/formoterol fumarate metered dose inhaler (BGF MDI) was shown to reduce exacerbations and improve lung function versus glycopyrronium/formoterol fumarate dihydrate (GFF) MDI in patients with moderate-to-very severe chronic obstructive pulmonary disease (COPD). However, whether the benefits related to the ICS component of BGF are driven by patients with high blood eosinophil counts (EOS) and/or airway reversibility has not been previously studied. <b>Methods:</b> KRONOS was a Phase III, double-blind, parallel-group, multicenter, randomized, controlled study of patients with moderate-to-very-severe COPD. Patients were randomized 2:2:1:1 to receive BGF 320/14.4/10 μg, GFF 14.4/10 μg, budesonide/formoterol fumarate dihydrate (BFF) MDI 320/10 μg via a single Aerosphere inhaler, or open-label budesonide/formoterol fumarate dihydrate dry powder inhaler 400/12 μg (BUD/FORM DPI; Symbicort Turbuhaler) twice-daily for 24 weeks. Efficacy outcomes included in this post-hoc analysis were change from baseline in morning pre-dose trough FEV1 over weeks 12–24 and the rate of moderate-to-severe and severe COPD exacerbations. Adverse events in the non-reversible subgroup are also reported. <b>Results:</b> Of 1896 patients analyzed, 948 (50%) were non-reversible and had EOS &#x3c;300 cells/mm<sup>3</sup>. In this group, BGF significantly improved morning pre-dose trough FEV<sub>1</sub> versus BFF and BUD/FORM (least squares mean treatment difference, 95% confidence interval [CI] 69 mL [39, 99], unadjusted <i>p</i>  &#x3c; 0.0001 and 51 mL [20, 81], unadjusted <i>p</i> = 0.0011, respectively) and was comparable to GFF. BGF also significantly reduced annual moderate-to-severe exacerbation rates versus GFF (rate ratio [95% CI] 0.53 [0.37, 0.76], unadjusted <i>p</i> = 0.0005), with numerical reductions observed versus BFF and BUD/FORM. These results were similar for the overall study population. Safety findings were generally similar between non-reversible patients with EOS &#x3c;300 cells/mm<sup>3</sup> and the overall population. <b>Conclusions:</b> In patients with moderate-to-very-severe COPD without airway reversibility and EOS &#x3c;300 cells/mm<sup>3</sup>, BGF significantly improved morning pre-dose trough FEV1 versus BFF and BUD/FORM and significantly reduced the rate of moderate-to-severe exacerbations versus GFF. These findings demonstrate that BGF can provide benefits for a broad range of patients with COPD, and that the overall findings of the KRONOS primary analysis were not driven by patients with reversible airflow obstruction or high eosinophil counts. <b>Trial registration:</b> ClinicalTrials.gov, NCT02497001. Registered 14 July 2015, https://clinicaltrials.gov/ct2/show/NCT02497001

scholarly journals Effect of Antiasthma Medication on Blood Eosinophil Count and Serum Immunoglobulin E Levels: A Randomized Controlled Study

2020 ◽  
pp. 33-39
Author(s):  
Wasim A. Wani ◽  
Sheeraz A. Dar ◽  
Khalid M. Kawosa ◽  
Mudasir Nazir ◽  
Ikhlas Ahmad ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Immunoglobulin E ◽  
Airflow Obstruction ◽  
Controlled Study ◽  
Blood Eosinophil ◽  
Blood Eosinophil Count ◽  
Serum Ige ◽  
Randomized Controlled ◽  
Chronic Inflammatory Condition ◽  
Eosinophil Counts

Background: Asthma is a chronic inflammatory condition of lung airways resulting in episodic airflow obstruction. Aims: The main objective of this study is to find the effect of antiasthma medication on serum IgE levels and blood eosinophil count. Study Design: This randomized controlled trial study was performed in children aged 6-15 years of age, with clinically stable and moderate persistent asthma. Results: The findings of this study indicate both group (Budesonide/formoterol group and budesonide group) patients experienced a significant decrease in serum IgE levels and blood eosinophil counts over the study period. However, the difference in two groups was not statistically significant. Conclusions: Inhaled steroids are effective in controlling systemic inflammation in asthma as evidenced by a decrease in IgE levels and eosinophil counts. However addition of LABA doesn’t have any additive effect.

scholarly journals Blood eosinophils and serum eosinophil cationic protein in patients with acute and chronic urticaria

1996 ◽  
Vol 5 (2) ◽  
pp. 113-115 ◽  
Author(s):  
G. Di Lorenzo ◽  
P. Mansueto ◽  
M. Melluso ◽  
G. Candore ◽  
D. Cigna ◽  
...  
Keyword(s):  
Chronic Urticaria ◽  
Eosinophil Cationic Protein ◽  
Chronic Idiopathic Urticaria ◽  
Blood Eosinophil ◽  
Cationic Protein ◽  
Acute Urticaria ◽  
Asymptomatic Patients ◽  
The Moment ◽  
Blood Eosinophils ◽  
Eosinophil Counts

We have analysed the relationship of blood eosinophil count and serum eosinophil cationic protein (ECP) levels in patients with acute and chronic idiopathic urticaria. The ECP levels and eosinophil counts were measured in the peripheral blood of 15 patients with acute urticaria, 25 with chronic idiopathic urticaria and 10 normal healthy subjects. Blood eosinophil counts and serum ECP levels increased in all patients with acute urticaria. Concerning patients affected by chronic urticaria, taking into account the recrudescence of the disease at the moment of taking the blood sample, only symptomatic patients showed increased eosinophil blood values whereas serum ECP levels were increased both in symptomatic and asymptomatic patients. Furthermore, serum ECP levels in chronic urticaria did not correlate with the peripheral eosinophil counts, as they did in acute urticaria. The results of the present study indicate that eosinophils may play a role in the inflammatory mechanisms in patients with acute and chronic urticaria showing a positive correlation between serum ECP levels and disease activity.

scholarly journals Association of Blood Eosinophil and Blood Neutrophil Counts with Asthma Exacerbations in the Copenhagen General Population Study

2017 ◽  
Vol 63 (4) ◽  
pp. 823-832 ◽  
Author(s):  
Signe Vedel-Krogh ◽  
Sune Fallgaard Nielsen ◽  
Peter Lange ◽  
Jørgen Vestbo ◽  
Børge Grønne Nordestgaard
Keyword(s):  
General Population ◽  
Disease Severity ◽  
Population Study ◽  
Blood Eosinophil ◽  
Blood Neutrophil ◽  
General Population Study ◽  
Asthma Exacerbations ◽  
Increased Risk ◽  
Blood Neutrophils ◽  
Eosinophil Counts

Abstract BACKGROUND Blood eosinophil count is a marker of eosinophilic airway inflammation and disease severity in asthma. However, blood neutrophil count might also be associated with disease severity. We tested the hypothesis that high blood eosinophil and neutrophil counts are both associated with the risk of asthma exacerbations among individuals with asthma from the general population. METHODS From the Copenhagen General Population Study with 81351 participants, we included 4838 with self-reported asthma. We recorded baseline blood eosinophil and neutrophil counts, and asthma exacerbations during follow-up in 2003–2011, defined as moderate (short-course treatment of prednisolone) or severe (hospitalization). RESULTS The multivariable-adjusted incidence rate ratios (IRRs) were 1.28 (95% CI, 1.06–1.55) for moderate exacerbations and 1.55 (1.20–2.00) for severe exacerbations for individuals with blood eosinophil counts &gt;0.29 × 109/L (highest tertile) vs individuals with blood eosinophil counts &lt;0.18 × 109/L (lowest tertile). For blood neutrophils, the multivariable-adjusted IRRs were 2.14 (1.74–2.63) for moderate exacerbations and 1.18 (0.89–1.55) for severe exacerbations for individuals with blood neutrophil counts &gt;4.85 × 109/L (highest tertile) vs individuals with blood neutrophil counts &lt;3.77 × 109/L (lowest tertile). Blood eosinophil and neutrophil counts interacted on moderate exacerbations (P = 3 × 10−4), but not on severe exacerbations. CONCLUSIONS High blood eosinophil counts are associated with an increased risk of both moderate and severe asthma exacerbations, while high blood neutrophil counts are associated with an increased risk of moderate, but not severe exacerbations.

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