Predictive value of eosinophils and neutrophils on clinical effects of ICS in COPD

Floor J Hartjes; Judith M Vonk; Alen Faiz; Pieter S Hiemstra; Thérèse S Lapperre; Huib A M Kerstjens; Dirkje S Postma; Maarten van den Berge; Groningen and Leiden Universities Corticosteroids in Obstructive Lung Disease (GLUCOLD) Study Group

doi:10.1111/resp.13312

Predictive value of eosinophils and neutrophils on clinical effects of ICS in COPD

Respirology. 2018 Nov;23(11):1023-1031. doi: 10.1111/resp.13312. Epub 2018 Apr 26.

Authors

Affiliations

¹ Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
² Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³ Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁴ Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
⁵ Department of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark.

PMID: 29696728
DOI: 10.1111/resp.13312

Abstract

Background and objective: Inflammation is present to a variable degree and composition in patients with COPD. This study investigates associations between both eosinophils and neutrophils in blood, sputum, airway wall biopsies and bronchoalveolar lavage (BAL) and their potential use as biomarkers for clinical response to inhaled corticosteroids (ICS).

Methods: In total, 114 steroid-naïve COPD patients of the Groningen Leiden Universities Corticosteroids in Obstructive Lung Disease (GLUCOLD) study using ICS or placebo during 30-month follow-up were included. Cell counts in blood, sputum, biopsies and BAL were evaluated at baseline. In addition, at baseline, 6 and 30 months, forced expiratory flow in 1 s (FEV₁ ), residual volume/total lung capacity (hyperinflation) and Clinical COPD Questionnaire were evaluated.

Results: Cross-sectional analyses at baseline showed that higher blood eosinophils were significantly associated with higher eosinophil counts in sputum, biopsies and BAL. However, blood neutrophils did not significantly correlate with neutrophil counts in the other compartments. Baseline eosinophils and neutrophils, in whichever compartment measured, did not predict longitudinal FEV₁ changes. Higher baseline biopsy eosinophils were associated with an increase in symptoms during 6- and 30-month ICS treatment. In addition, higher biopsy neutrophils were associated with a more marked reduction in hyperinflation during 6-month ICS treatment compared with placebo.

Conclusion: Our findings indicate that blood eosinophils reflect eosinophils in other compartments, in contrast to neutrophils, in ICS-naïve COPD patients. Both baseline eosinophils and neutrophils do not predict ICS-induced lung function changes over a period of 6-30 months. The associations of biopsy eosinophils with worsening respiratory symptoms and biopsy neutrophils with improvement in hyperinflation during ICS treatment deserve further investigation.

Keywords: biomarkers; chronic obstructive pulmonary disease; eosinophils; neutrophils; steroids.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cross-Sectional Studies
Eosinophils*
Female
Glucocorticoids* / administration & dosage
Glucocorticoids* / adverse effects
Humans
Leukocyte Count / methods*
Lung* / drug effects
Lung* / physiopathology
Male
Middle Aged
Netherlands
Neutrophils*
Predictive Value of Tests
Pulmonary Disease, Chronic Obstructive* / blood
Pulmonary Disease, Chronic Obstructive* / diagnosis
Pulmonary Disease, Chronic Obstructive* / drug therapy
Pulmonary Disease, Chronic Obstructive* / physiopathology
Respiratory Function Tests / methods
Treatment Outcome

Substances

Glucocorticoids

Abstract

Publication types

MeSH terms

Substances

Grants and funding