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Association of sputum and blood eosinophil concentrations with clinical measures of COPD severity: an analysis of the SPIROMICS cohort

R.G. Crystal, E.E. Carretta, M.B. Scholand, M.K. Han, A.P. Comellas, J.L. Curtis, R.C. Boucher, E. Kleerup, E.R. Bleecker, R.P. Bowler, S. Christenson, E.C. Oelsner (+31 others)
2017

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Increased concentrations of eosinophils in blood and sputum in chronic obstructive pulmonary disease (COPD) have been associated with increased frequency of exacerbations, reduced lung function, and corticosteroid responsiveness. We aimed to assess whether high eosinophil concentrations in either sputum or blood are associated with a severe COPD phenotype, including greater exacerbation frequency, and whether blood eosinophils are predictive of sputum eosinophils. Methods We did a multicentre
more » ... servational study analysing comprehensive baseline data from SPIROMICS in patients with COPD aged 40–80 years who had a smoking history of at least 20 pack-years, recruited from six clinical sites and additional subsites in the USA between Nov 12, 2010, and April 21, 2015. Inclusion criteria for this analysis were SPIROMICS baseline visit data with complete blood cell counts and, in a subset, acceptable sputum counts. We stratified patients on the basis of blood and sputum eosinophil concentrations and compared their demographic characteristics, as well as results from questionnaires, clinical assessments, and quantitative CT (QCT). We also analysed whether blood eosinophil concentrations reliably predicted sputum eosinophil concentrations. This study is registered with ClinicalTrials.gov (NCT01969344). Findings Of the 2737 patients recruited to SPIROMICS, 2499 patients were smokers and had available blood counts, and so were stratified by mean blood eosinophil count: 1262 patients with low (<200 cells per μL) and 1237 with high (≥200 cells per μL) blood eosinophil counts. 827 patients were eligible for stratification by mean sputum eosinophil percentage: 656 with low (<1·25%) and 171 with high (≥1·25%) sputum eosinophil percentages. The high sputum eosinophil group had significantly lower median FEV1 percentage predicted than the low sputum eosinophil group both before (65·7% [IQR 51·8–81·3] vs 75·7% [59·3–90·2], p<0·0001) and after (77·3% [63·1–88·5] vs 82·9% [67·8–95·9], p=0·001) bronchodilation. QCT [...]
doi:10.17615/xrb4-be46 fatcat:ip4kegagwrhv7ddtu6ggsfvgqa
Citation

R.G. Crystal, E.E. Carretta, M.B. Scholand, M.K. Han, A.P. Comellas, J.L. Curtis, R.C. Boucher, E. Kleerup, E.R. Bleecker, R.P. Bowler, S. Christenson, E.C. Oelsner, C.M. Doerschuk, N.E. Alexis, A.T. Hastie, J.M. Wells, D.A. Meyers, R.J. Kaner, P.G. Woodruff, S.I. Rennard, C.M. Freeman, D.P. Tashkin, L.M. LaVange, E.A. Hoffman, W.K. ONeal, N. Putcha, C.B. Cooper, R.E. Kanner, G.J. Criner, Paine, R., III, R.G. Barr, D.J. Couper, R.A. Wise, M.T. Dransfield, W.H. Anderson, F.J. Martinez, X. Li, S.P. Peters, J.A. Krishnan, N.N. Hansel, S.C. Lazarus, V.E. Ortega, Newell, J.D., Jr. "Association of sputum and blood eosinophil concentrations with clinical measures of COPD severity: an analysis of the SPIROMICS cohort." (2017)