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Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort

Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort
Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort
Eosinophilic inflammation in COPD predicts response to treatment especially corticosteroids. We studied the nature of eosinophilic inflammation in COPD prospectively to examine the stability of this phenotype and its dynamics across exacerbations and its associations with clinical phenotype, exacerbations and infection.127 patients aged 40–85 with moderate-severe COPD underwent repeated blood and sputum sampling at stable visits and within 72 h of exacerbation for one year. Blood eosinophils ≥2% was prevalent at baseline and predicted both predominantly raised stable state eosinophils across the year (AUC 0.841, 95%CI 0.755; 0.928), and increased risk of eosinophilic inflammation at exacerbation (OR 9.16 p<0.001). Eosinophils≥2% at exacerbation and eosinophil predominance at stable visits were associated with a lower risk of bacterial presence at exacerbation (OR 0.49, p=0.049 and OR 0.25, p=0.065 respectively). Bacterial infection at exacerbation was highly seasonal (Winter vs Summer OR 4.74, p=0.011) in predominantly eosinophilic patients.Eosinophilic inflammation is a common and stable phenotype in COPD. Blood eosinophil counts in the stable state can predict the nature of inflammation at future exacerbations which when combined with an understanding of seasonal variation provides the basis for the development of new treatment paradigms for this important condition
0903-1936
Kim, Viktoriya, Leonidovna
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COOMBS, NGAIRE A
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Staples, Karl J
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Ostridge, Kristoffer
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Williams, Nicholas, Paul
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Wootton, Stephen A
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Devaster, Jeanne-Marie
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Aris, Emmanuel
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Clarke, Stuart C
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Tuck, Andrew C
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Bourne, Simon Charles
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Wilkinson, Tom MA
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Kim, Viktoriya, Leonidovna
b7fe2e0f-95b4-4224-96a8-a7e66155625e
COOMBS, NGAIRE A
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Staples, Karl J
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Ostridge, Kristoffer
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Williams, Nicholas, Paul
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Wootton, Stephen A
bf47ef35-0b33-4edb-a2b0-ceda5c475c0c
Devaster, Jeanne-Marie
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Aris, Emmanuel
2203e7f8-8fa1-40c0-be30-99f142655835
Clarke, Stuart C
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Tuck, Andrew C
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Bourne, Simon Charles
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Wilkinson, Tom MA
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Kim, Viktoriya, Leonidovna, COOMBS, NGAIRE A, Staples, Karl J, Ostridge, Kristoffer, Williams, Nicholas, Paul, Wootton, Stephen A, Devaster, Jeanne-Marie, Aris, Emmanuel, Clarke, Stuart C, Tuck, Andrew C, Bourne, Simon Charles and Wilkinson, Tom MA (2017) Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort. European Respiratory Journal. (doi:10.1183/13993003.00853-2017).

Record type: Article

Abstract

Eosinophilic inflammation in COPD predicts response to treatment especially corticosteroids. We studied the nature of eosinophilic inflammation in COPD prospectively to examine the stability of this phenotype and its dynamics across exacerbations and its associations with clinical phenotype, exacerbations and infection.127 patients aged 40–85 with moderate-severe COPD underwent repeated blood and sputum sampling at stable visits and within 72 h of exacerbation for one year. Blood eosinophils ≥2% was prevalent at baseline and predicted both predominantly raised stable state eosinophils across the year (AUC 0.841, 95%CI 0.755; 0.928), and increased risk of eosinophilic inflammation at exacerbation (OR 9.16 p<0.001). Eosinophils≥2% at exacerbation and eosinophil predominance at stable visits were associated with a lower risk of bacterial presence at exacerbation (OR 0.49, p=0.049 and OR 0.25, p=0.065 respectively). Bacterial infection at exacerbation was highly seasonal (Winter vs Summer OR 4.74, p=0.011) in predominantly eosinophilic patients.Eosinophilic inflammation is a common and stable phenotype in COPD. Blood eosinophil counts in the stable state can predict the nature of inflammation at future exacerbations which when combined with an understanding of seasonal variation provides the basis for the development of new treatment paradigms for this important condition

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AERIS eosinophils revision submitted - Accepted Manuscript
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Accepted/In Press date: 16 July 2017
e-pub ahead of print date: 12 October 2017

Identifiers

Local EPrints ID: 412624
URI: https://eprints.soton.ac.uk/id/eprint/412624
ISSN: 0903-1936
PURE UUID: ab80d4e0-ead2-45d7-8ff9-f01808a6509f
ORCID for Karl J Staples: ORCID iD orcid.org/0000-0003-3844-6457
ORCID for Stuart C Clarke: ORCID iD orcid.org/0000-0002-7009-1548

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Date deposited: 24 Jul 2017 16:32
Last modified: 10 Dec 2019 05:55

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