Interpreting blood eosinophil counts in health and obstructive lung disease

2022 ◽  
Vol 59 (1) ◽  
pp. 2102180
Author(s):  
Yunus Çolak ◽  
Peter Lange
2019 ◽  
Vol 53 (5) ◽  
pp. 1900164 ◽  
Author(s):  
Dave Singh ◽  
Alvar Agusti ◽  
Antonio Anzueto ◽  
Peter J. Barnes ◽  
Jean Bourbeau ◽  
...  

Precision medicine is a patient-specific approach that integrates all relevant clinical, genetic and biological information in order to optimise the therapeutic benefit relative to the possibility of side-effects for each individual. Recent clinical trials have shown that higher blood eosinophil counts are associated with a greater efficacy of inhaled corticosteroids (ICSs) in chronic obstructive pulmonary disease (COPD) patients. Blood eosinophil counts are a biomarker with potential to be used in clinical practice, to help target ICS treatment with more precision in COPD patients with a history of exacerbations despite appropriate bronchodilator treatment.The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 pharmacological treatment algorithms, based on the ABCD assessment, can be applied relatively easily to treatment-naive individuals at initial presentation. However, their use is more problematic during follow-up in patients who are already on maintenance treatment. There is a need for a different system to guide COPD pharmacological management during follow-up.Recent large randomised controlled trials have provided important new information concerning the therapeutic effects of ICSs and long-acting bronchodilators on exacerbations. The new evidence regarding blood eosinophils and inhaled treatments, and the need to distinguish between initial and follow-up pharmacological management, led to changes in the GOLD pharmacological treatment recommendations. This article explains the evidence and rationale for the GOLD 2019 pharmacological treatment recommendations.


2021 ◽  
pp. 2003823
Author(s):  
Hye Yun Park ◽  
Yoosoo Chang ◽  
Danbee Kang ◽  
Yun Soo Hong ◽  
Di Zhao ◽  
...  

The impact of blood eosinophil counts on the development of chronic obstructive lung disease (COPD) is unknown. We investigated whether a higher blood eosinophil counts was associated with the risk of developing obstructive lung disease (OLD) in a large cohort of men and women free lung disease at baseline.Cohort study of 359 456 Korean adults without a history of asthma and without OLD at baseline who participated in health screening exams including spirometry. OLD was defined as pre-bronchodilator FEV1/FVC<0.7 and FEV1<80% predicted.After a median follow-up of 5.6 years (interquartile range, 2.9–9.2), 5008 participants developed incident OLD (incidence rate, 2.1 per 1000 person-years; 95% CI, 2.1–2.2). In the fully-adjusted model, the HR (95% CI) for incident OLD comparing eosinophil counts of 100–<200, 200–<300, 300–<500 and ≥500 cells·μL−1 to <100 cells·μL−1 were 1.07 (1.00–1.15), 1.30 (1.20–1.42), 1.46 (1.33–1.60) and 1.72 (1.51–1.95) (p for trend <0.001). These associations were consistent in clinically relevant subgroups, including never, former, and current smokers.In this large longitudinal cohort study, blood eosinophil counts were positively associated with the risk of developing of OLD. Our findings indicate a potential role of eosinophil count as an independent risk factor for developing COPD.


Tsitologiya ◽  
2018 ◽  
Vol 60 (7) ◽  
pp. 536-539
Author(s):  
A. S. Ulitina Ulitina ◽  
◽  
E. I. Vsevolodskaia ◽  
Zh. A. Mironova ◽  
S. D. Gorbunkov ◽  
...  

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