Blood eosinophil count in patients with COPD on inhaled corticosteroid in comparison with healthy smoker and nonsmoker control
Dr Marwa Sayed Daif; Amani Mohamed Abdel Ghanib; Noha Othman Ahmeda;
Abstract
Background
Chronic obstructive pulmonary disease (COPD) is associated with acute and
chronic pulmonary inflammation in the lung and as a systemic inflammation.
The blood eosinophil counts are now recommended by the Global Initiative for
the Management of Obstructive Lung Disease as a guide of inhaled corticosteroid
use in clinical practice, as it can predict its effect on the rate of COPD exacerbation.
The increasing peripheral blood eosinophilic count in patients with COPD could
explain the systemiceosinophiliain COPD,whichcausesincreasedlungeosinophil
count in these patients, especially those on inhaled corticosteroids (ICS).
Patients and methods
The study included 56 patients with COPD who were active smokers with pack
years beyond 10 as cases. The control group includes 60 patients as healthy
nonsmokers (HNS) and 66 patients as healthy current smokers (HS), with pack
year beyond 10. Prebronchodilator and postbronchodilator spirometry was done in
the pulmonary function unit of the Chest Department, Ain Shams University
Hospital, to confirm or to exclude the COPD diagnosis. The COPD cases were
categorized as per the Global Initiative for the Management of Obstructive Lung
Disease severity assessment guideline and were receiving budesonide 800μg/day
and formoterol 24μg/day or salmeterol 100μg and fluticasone propionate 500μg
twice daily. Skin prick test and complete blood count for its differential and
eosinophil count were done for all cases.
Results
The study included 56 patients with COPD who were active smokers and received
ICS. The control group included 60 patients as HNS along with 66 patients as
healthy current smokers. The HNS group showed the least total leukocytic count of
5588.33±1081.13/μl and the least eosinophilic count of 99.47±91.51/μl, whereas
the COPDgroupshowedthehighesttotalleukocyticcount.Astatisticallysignificant
relation was found also between COPD patients’ eosinophil count and the use of
ICS, with P value 0.000.
Conclusion
The peripheral blood eosinophil counts collected from patients with COPD on ICS
are significantly higher than the patients with COPD who are not using ICS and the
healthy smoker and nonsmoker control group.
Keywords:
chronic obstructive pulmonary disease, eosinophils, inhaled corticosteroids
Chronic obstructive pulmonary disease (COPD) is associated with acute and
chronic pulmonary inflammation in the lung and as a systemic inflammation.
The blood eosinophil counts are now recommended by the Global Initiative for
the Management of Obstructive Lung Disease as a guide of inhaled corticosteroid
use in clinical practice, as it can predict its effect on the rate of COPD exacerbation.
The increasing peripheral blood eosinophilic count in patients with COPD could
explain the systemiceosinophiliain COPD,whichcausesincreasedlungeosinophil
count in these patients, especially those on inhaled corticosteroids (ICS).
Patients and methods
The study included 56 patients with COPD who were active smokers with pack
years beyond 10 as cases. The control group includes 60 patients as healthy
nonsmokers (HNS) and 66 patients as healthy current smokers (HS), with pack
year beyond 10. Prebronchodilator and postbronchodilator spirometry was done in
the pulmonary function unit of the Chest Department, Ain Shams University
Hospital, to confirm or to exclude the COPD diagnosis. The COPD cases were
categorized as per the Global Initiative for the Management of Obstructive Lung
Disease severity assessment guideline and were receiving budesonide 800μg/day
and formoterol 24μg/day or salmeterol 100μg and fluticasone propionate 500μg
twice daily. Skin prick test and complete blood count for its differential and
eosinophil count were done for all cases.
Results
The study included 56 patients with COPD who were active smokers and received
ICS. The control group included 60 patients as HNS along with 66 patients as
healthy current smokers. The HNS group showed the least total leukocytic count of
5588.33±1081.13/μl and the least eosinophilic count of 99.47±91.51/μl, whereas
the COPDgroupshowedthehighesttotalleukocyticcount.Astatisticallysignificant
relation was found also between COPD patients’ eosinophil count and the use of
ICS, with P value 0.000.
Conclusion
The peripheral blood eosinophil counts collected from patients with COPD on ICS
are significantly higher than the patients with COPD who are not using ICS and the
healthy smoker and nonsmoker control group.
Keywords:
chronic obstructive pulmonary disease, eosinophils, inhaled corticosteroids
Other data
| Title | Blood eosinophil count in patients with COPD on inhaled corticosteroid in comparison with healthy smoker and nonsmoker control | Authors | Dr Marwa Sayed Daif ; Amani Mohamed Abdel Ghanib; Noha Othman Ahmeda | Keywords | chronic obstructive pulmonary disease, eosinophils, inhaled corticosteroids | Issue Date | 28-May-2021 | Publisher | Noha Othman Ahmed, Lecturer of Chest Diseases, Ain Shams | Journal | Egyptian Journal of Chest Diseases and Tuberculosis | Description | Introduction Chronic obstructive pulmonary disease (COPD) is associated with acute and chronic pulmonary inflammation in the lung and the airways not to mention the systemic inflammation. It is presented as a progressive airflow obstruction in response to noxious particles or gases [1,2]. Theblood eosinophil counts are now recommended by the global initiative for the management of obstructive lung disease (GOLD) as a guide of inhaled corticosteroid (ICS) use in clinical practice, as it can predict the effect of ICS on the rate of exacerbation and improvement of lung function. On the contrary, ICS use is associated with adverse events, the most concerning being pneumonia [1,3]. The eosinophilic airway inflammation has been defined in some patients with either stable or exacerbated COPD [4]. However, eosinophilic count less than 500 cells/μl seemed to be associated with increased risk of sepsis and pneumonia in patients with an acute exacerbation of COPD [5]. |
DOI | DOI: 10.4103/ejcdt.ejcdt_75_20 |
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