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

and the Groningen and Leiden Universities Corticosteroids in Obstructive Lung Disease (GLUCOLD) Study Group, 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*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 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).

MethodsResultsIn total, 114 steroid-naive 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 30months, forced expiratory flow in 1s (FEV1), residual volume/total lung capacity (hyperinflation) and Clinical COPD Questionnaire were evaluated.

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.

ConclusionOur findings indicate that blood eosinophils reflect eosinophils in other compartments, in contrast to neutrophils, in ICS-naive COPD patients. Both baseline eosinophils and neutrophils do not predict ICS-induced lung function changes over a period of 6-30months. 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
Early online date26-Apr-2018
DOIs
Publication statusPublished - Nov-2018

Keywords

  • biomarkers
  • chronic obstructive pulmonary disease
  • eosinophils
  • neutrophils
  • steroids
  • OBSTRUCTIVE PULMONARY-DISEASE
  • INHALED CORTICOSTEROIDS
  • BLOOD EOSINOPHILS
  • LUNG-FUNCTION
  • ASTHMA
  • INFLAMMATION
  • FLUTICASONE
  • SPUTUM
  • EXACERBATIONS
  • OVERLAP

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