{"title":"在现实世界中,血液嗜酸性粒细胞计数作为慢性阻塞性肺疾病恶化的预测性生物标志物。","authors":"Moegi Komura, Tadashi Sato, Yohei Suzuki, Hitomi Yoshikawa, Naoko Arano Nitta, Mika Hayashi, Eriko Kuwasaki, Kimiko Horikoshi, Toshihiko Nishioki, Mikiko Mori, Yuzo Kodama, Shinichi Sasaki, Kazuhisa Takahashi","doi":"10.1155/2023/3302405","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, and COPD exacerbation worsens the prognosis. Eosinophilic airway inflammation is a COPD phenotype that causes COPD exacerbation and is correlated with peripheral blood eosinophil count. We analyzed real-world data of COPD patients to assess the risk factors of COPD exacerbation focusing on blood eosinophils.</p><p><strong>Materials and methods: </strong>Patients with COPD who visited our hospital between January 1, 2018, and December 31, 2018, were recruited, and their background information, spirometry data, laboratory test results, and moderate-to-severe exacerbation events during the one-year follow-up period were collected from the electronic medical records and analyzed. The COPD exacerbation risk factors were assessed using univariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Twenty-two of 271 (8.1%) patients experienced moderate-to-severe exacerbation. Patients with exacerbation showed worse pulmonary function, and we found that a high blood eosinophil count (≥350 cells/<i>μ</i>L; <i>p</i>=0.014), low % FEV1 (<50%; <i>p</i>=0.002), increase in white blood cell (≥9000 cells/<i>μ</i>L; <i>p</i>=0.039), and use of home oxygen therapy (<i>p</i>=0.005) were risk factors for future exacerbations. We also found a strong correlation between eosinophil count cut-offs and exacerbation risk (<i>r</i> = 0.89, <i>p</i> < 0.001). On the other hand, there was no relation between exacerbation risk and inhalation therapy for COPD.</p><p><strong>Conclusion: </strong>In a real-world setting, peripheral blood eosinophil count could be a predictor of future COPD exacerbation.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234729/pdf/","citationCount":"1","resultStr":"{\"title\":\"Blood Eosinophil Count as a Predictive Biomarker of Chronic Obstructive Pulmonary Disease Exacerbation in a Real-World Setting.\",\"authors\":\"Moegi Komura, Tadashi Sato, Yohei Suzuki, Hitomi Yoshikawa, Naoko Arano Nitta, Mika Hayashi, Eriko Kuwasaki, Kimiko Horikoshi, Toshihiko Nishioki, Mikiko Mori, Yuzo Kodama, Shinichi Sasaki, Kazuhisa Takahashi\",\"doi\":\"10.1155/2023/3302405\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, and COPD exacerbation worsens the prognosis. Eosinophilic airway inflammation is a COPD phenotype that causes COPD exacerbation and is correlated with peripheral blood eosinophil count. We analyzed real-world data of COPD patients to assess the risk factors of COPD exacerbation focusing on blood eosinophils.</p><p><strong>Materials and methods: </strong>Patients with COPD who visited our hospital between January 1, 2018, and December 31, 2018, were recruited, and their background information, spirometry data, laboratory test results, and moderate-to-severe exacerbation events during the one-year follow-up period were collected from the electronic medical records and analyzed. The COPD exacerbation risk factors were assessed using univariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Twenty-two of 271 (8.1%) patients experienced moderate-to-severe exacerbation. Patients with exacerbation showed worse pulmonary function, and we found that a high blood eosinophil count (≥350 cells/<i>μ</i>L; <i>p</i>=0.014), low % FEV1 (<50%; <i>p</i>=0.002), increase in white blood cell (≥9000 cells/<i>μ</i>L; <i>p</i>=0.039), and use of home oxygen therapy (<i>p</i>=0.005) were risk factors for future exacerbations. We also found a strong correlation between eosinophil count cut-offs and exacerbation risk (<i>r</i> = 0.89, <i>p</i> < 0.001). On the other hand, there was no relation between exacerbation risk and inhalation therapy for COPD.</p><p><strong>Conclusion: </strong>In a real-world setting, peripheral blood eosinophil count could be a predictor of future COPD exacerbation.</p>\",\"PeriodicalId\":9416,\"journal\":{\"name\":\"Canadian respiratory journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234729/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian respiratory journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/3302405\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian respiratory journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/3302405","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 1
摘要
慢性阻塞性肺疾病(COPD)是导致死亡的第三大原因,COPD恶化会使预后恶化。嗜酸性气道炎症是COPD的一种表型,可导致COPD加重,并与外周血嗜酸性粒细胞计数相关。我们分析了COPD患者的真实世界数据,以评估COPD加重的危险因素,重点是血液嗜酸性粒细胞。材料与方法:招募2018年1月1日至2018年12月31日在我院就诊的COPD患者,收集其电子病历1年随访期间的背景信息、肺活量测定数据、实验室检查结果及中重度加重事件进行分析。采用单因素和多因素logistic回归分析评估COPD加重危险因素。结果:271例患者中有22例(8.1%)出现中度至重度恶化。加重期患者肺功能变差,血嗜酸性粒细胞计数高(≥350细胞/μL;p=0.014), % FEV1低(p=0.002),白细胞升高(≥9000个细胞/μL;P =0.039)和使用家庭氧疗(P =0.005)是未来加重的危险因素。我们还发现嗜酸性粒细胞计数临界值与恶化风险之间存在很强的相关性(r = 0.89, p < 0.001)。另一方面,COPD的恶化风险与吸入疗法之间没有关系。结论:在现实环境中,外周血嗜酸性粒细胞计数可能是未来COPD恶化的预测因子。
Blood Eosinophil Count as a Predictive Biomarker of Chronic Obstructive Pulmonary Disease Exacerbation in a Real-World Setting.
Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, and COPD exacerbation worsens the prognosis. Eosinophilic airway inflammation is a COPD phenotype that causes COPD exacerbation and is correlated with peripheral blood eosinophil count. We analyzed real-world data of COPD patients to assess the risk factors of COPD exacerbation focusing on blood eosinophils.
Materials and methods: Patients with COPD who visited our hospital between January 1, 2018, and December 31, 2018, were recruited, and their background information, spirometry data, laboratory test results, and moderate-to-severe exacerbation events during the one-year follow-up period were collected from the electronic medical records and analyzed. The COPD exacerbation risk factors were assessed using univariate and multivariate logistic regression analyses.
Results: Twenty-two of 271 (8.1%) patients experienced moderate-to-severe exacerbation. Patients with exacerbation showed worse pulmonary function, and we found that a high blood eosinophil count (≥350 cells/μL; p=0.014), low % FEV1 (<50%; p=0.002), increase in white blood cell (≥9000 cells/μL; p=0.039), and use of home oxygen therapy (p=0.005) were risk factors for future exacerbations. We also found a strong correlation between eosinophil count cut-offs and exacerbation risk (r = 0.89, p < 0.001). On the other hand, there was no relation between exacerbation risk and inhalation therapy for COPD.
Conclusion: In a real-world setting, peripheral blood eosinophil count could be a predictor of future COPD exacerbation.
期刊介绍:
Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.