Eosinopenia in bronchiectasis: A novel biomarker for morbidity and mortality.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM Chronic Respiratory Disease Pub Date : 2025-01-01 DOI:10.1177/14799731241296847

Shimon Izhakian, Ravid Yehezkely, Assaf Frajman, Ori Mekiten, Ori Hadar, Avigail Rockland, Liel Malka, Lev Freidkin, Dror Rosengarten, Mordechai R Kramer

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Abstract

Background: The paradigm of bronchiectasis is shifting away from its exclusive characterization as a neutrophilic condition. Patients with bronchiectasis and high eosinophil levels have been found to have a specific phenotype, but the clinical effect of eosinopenia remains unclear.

Method: A retrospective, single-center, observational study was conducted at a tertiary medical center. Adult patients under follow-up for bronchiectasis from January 2007 to August 2020 were categorized by blood eosinophil count (BEC) as follows: eosinopenia (<100 cells/µL), normal (100-299 cells/µL), and eosinophilia (≥300 cells/µL). Data on the first hospitalization due to exacerbation and the community exacerbation rate in the first year of follow-up were analyzed. Mortality rates were assessed up to the end of follow-up on September 1, 2023.

Results: The cohort included 724 patients (100%), 61% female (n = 442), of mean age 61 ± 16 years. The median follow-up period was 7.5 years (IQR: 5.1-10.8). Eosinopenia was found in 14.7% (n = 107), normal BEC in 56.6% (n = 417), and eosinophilia in 28.7% (n = 200). Patients with eosinopenia had a higher hazard ratio for first hospitalization than the normal-count group (1.71, 95% CI 1.11-2.64, p = .01) and the highest mean exacerbation rate (p = .04). On multivariate analysis, eosinopenia was significantly associated with higher mortality (HR 2.15, 95% CI 1.42-3.24, p < .001) after adjusting for age and sex.

Conclusion: Eosinopenia in bronchiectasis emerged as a potential biomarker for adverse outcomes. Further study of its role in disease behavior may provide insights for the development of therapeutic strategies.

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支气管扩张中嗜酸性粒细胞减少：一种新的发病率和死亡率的生物标志物。

背景：支气管扩张的范式正在从其作为中性粒细胞疾病的排他性特征转移。支气管扩张和高嗜酸性粒细胞水平的患者已发现具有特定的表型，但临床影响的嗜酸性粒细胞减少尚不清楚。方法：在某三级医疗中心进行回顾性、单中心、观察性研究。2007年1月至2020年8月随访的成年支气管扩张患者按血嗜酸性粒细胞计数（BEC）分类如下：嗜酸性粒细胞减少(结果：队列纳入724例（100%），61%为女性（n = 442），平均年龄61±16岁。中位随访期为7.5年（IQR: 5.1-10.8）。红细胞减少14.7% (n = 107)， BEC正常56.6% (n = 417)，嗜酸性粒细胞增多28.7% （n = 200）。首次住院时，红细胞减少患者的危险比高于正常计数组（1.71,95% CI 1.11-2.64, p = 0.01），平均加重率最高（p = 0.04）。在多变量分析中，校正年龄和性别后，红细胞减少与较高的死亡率显著相关（HR 2.15, 95% CI 1.42-3.24, p < 0.001）。结论：支气管扩张患者嗜酸性粒细胞减少是不良结局的潜在生物标志物。进一步研究其在疾病行为中的作用可能为治疗策略的发展提供见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chronic Respiratory Disease RESPIRATORY SYSTEM-

CiteScore

5.90

自引率

7.30%

发文量

审稿时长

11 weeks

期刊介绍： Chronic Respiratory Disease is a peer-reviewed, open access, scholarly journal, created in response to the rising incidence of chronic respiratory diseases worldwide. It publishes high quality research papers and original articles that have immediate relevance to clinical practice and its multi-disciplinary perspective reflects the nature of modern treatment. The journal provides a high quality, multi-disciplinary focus for the publication of original papers, reviews and commentary in the broad area of chronic respiratory disease, particularly its treatment and management.