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

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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

21 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1023-1031
Number of pages9
JournalRespirology
Volume23
Issue number11
DOIs
Publication statusPublished - Nov 2018
Externally publishedYes

Bibliographical note

Funding Information:
The authors thank all the patients for their cooperation in the study. The study was supported by funding from The Netherlands Organization for Scientific Research (NWO), Netherlands Asthma Foundation (NAF), The University Medical Center Gro-ningen (UMCG), The University of Groningen (RUG) and Leiden University Medical Center (LUMC). They provided funding for the study, but had no role in the writing or submitting of the manuscript. P.S.H. has received further financial support by NOW and NAF.

Funding Information:
The authors thank all the patients for their cooperation in the study. The study was supported by funding from The Netherlands Organization for Scientific Research (NWO), Netherlands Asthma Foundation (NAF), The University Medical Center Groningen (UMCG), The University of Groningen (RUG) and Leiden University Medical Center (LUMC). They provided funding for the study, but had no role in the writing or submitting of the manuscript. P.S.H. has received further financial support by NOW and NAF.

Publisher Copyright:
© 2018 Asian Pacific Society of Respirology

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