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Airway Eosinophilia on Bronchoalveolar Lavage and the Risk of Exacerbations in COPD Ho, Chun-man Germain; Milne, Stephen; Xuan, Li; Yang, Chen Xi; Leitao Filho, Fernando Sergio; Cheung, Chung Yan; Yang, Julia Shun Wei; Hernández Cordero, Ana I; Yang, Cheng Wei Tony; Shaipanich, Tawimas; Van Eeden, Stephan; Leung, Janice M.; Lam, Stephen; Sin, Don

Abstract

The associations between airway eosinophilia, measured in sputum or peripheral blood, and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are inconsistent. We therefore aimed to determine the association between eosinophilia in bronchoalveolar lavage (BAL) fluid and AECOPD in a clinical cohort. We analyzed differential cell counts from baseline BAL fluid in participants in the DISARM clinical trial (Clinicaltrials.gov #NCT02833480) and classified participants by the presence or absence of BAL eosinophilia (>1% of total leukocytes). We determined the association between BAL eosinophilia and AECOPD over 1 year of follow-up using negative binomial regression and Cox proportional hazards test. N = 63 participants were randomized, and N = 57 had BAL differential cell counts available. Participants with BAL eosinophilia (N = 21) had a significantly increased rate of acute exacerbations (unadjusted incidence rate ratio (IRR) 2.0, p = 0.048; adjusted IRR 2.24, p = 0.04) and a trend toward greater probability of acute exacerbation (unadjusted hazard ratio (HR) 1.74, p = 0.13; adjusted HR 2.3, p = 0.1) in the year of follow-up compared to participants without BAL eosinophilia (N = 36). These associations were not observed for BAL neutrophilia (N = 41 participants), BAL lymphocytosis (N = 27 participants) or peripheral blood eosinophilia at various threshold definitions (2%, N = 37; 3%, N = 27; 4%, N = 16). BAL may therefore be a sensitive marker of eosinophilic inflammation in the distal lung and may be of benefit for risk stratification or biomarker-guided therapy in COPD.

Item Metadata

Title
Airway Eosinophilia on Bronchoalveolar Lavage and the Risk of Exacerbations in COPD
Creator
Ho, Chun-man Germain; Milne, Stephen; Xuan, Li; Yang, Chen Xi; Leitao Filho, Fernando Sergio; Cheung, Chung Yan; Yang, Julia Shun Wei; Hernández Cordero, Ana I; Yang, Cheng Wei Tony; Shaipanich, Tawimas; Van Eeden, Stephan; Leung, Janice M.; Lam, Stephen; Sin, Don
Contributor
University of British Columbia. Centre for Heart Lung Innovation; Providence Health Care (Vancouver, B.C.); BC Cancer Research Centre. Integrative Oncology
Publisher
Multidisciplinary Digital Publishing Institute
Date Issued
2022-06-15
Description
The associations between airway eosinophilia, measured in sputum or peripheral blood, and acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are inconsistent. We therefore aimed to determine the association between eosinophilia in bronchoalveolar lavage (BAL) fluid and AECOPD in a clinical cohort. We analyzed differential cell counts from baseline BAL fluid in participants in the DISARM clinical trial (Clinicaltrials.gov #NCT02833480) and classified participants by the presence or absence of BAL eosinophilia (>1% of total leukocytes). We determined the association between BAL eosinophilia and AECOPD over 1 year of follow-up using negative binomial regression and Cox proportional hazards test. N = 63 participants were randomized, and N = 57 had BAL differential cell counts available. Participants with BAL eosinophilia (N = 21) had a significantly increased rate of acute exacerbations (unadjusted incidence rate ratio (IRR) 2.0, p = 0.048; adjusted IRR 2.24, p = 0.04) and a trend toward greater probability of acute exacerbation (unadjusted hazard ratio (HR) 1.74, p = 0.13; adjusted HR 2.3, p = 0.1) in the year of follow-up compared to participants without BAL eosinophilia (N = 36). These associations were not observed for BAL neutrophilia (N = 41 participants), BAL lymphocytosis (N = 27 participants) or peripheral blood eosinophilia at various threshold definitions (2%, N = 37; 3%, N = 27; 4%, N = 16). BAL may therefore be a sensitive marker of eosinophilic inflammation in the distal lung and may be of benefit for risk stratification or biomarker-guided therapy in COPD.
Subject
biomarkers; chronic obstructive pulmonary disease; eosinophilia; bronchoscopy
Genre
Article
Type
Text
Language
eng
Date Available
2022-09-13
Provider
Vancouver : University of British Columbia Library
Rights
CC BY 4.0
DOI
10.14288/1.0419372
URI
http://hdl.handle.net/2429/82694
Affiliation
Medicine, Faculty of; Medicine, Department of
Citation
Biomedicines 10 (6): 1412 (2022)
Publisher DOI
10.3390/biomedicines10061412
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
https://creativecommons.org/licenses/by/4.0/
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CC BY 4.0