PhD Scientific Days 2018

Budapest, April 19–20, 2018

COPD EXACERBATIONS WITH INCREASED BLOOD EOSINOPHIL PERCENTAGE ARE ASSOCIATED WITH LESS SYSTEMIC INFLAMMATION AND BETTER LUNG FUNCTION IMPROVEMENT

Lázár, Zsófia

1Dept. Pulmonology, Semmelweis University, Budapest

Language of the presentation

English

Text of the abstract

Introduction: Patients with COPD exacerbations (COPD-E) and increased blood eosinophil counts can represent a clinical phenotype that may respond better to systemic steroid therapy. However, data from tertiary clinical care, where usually more severe patients are treated, are missing.
Aims: To clinically characterize patients with acute severe COPD-E with and without increased blood eosinophil percentage, who are hospitalized at a university clinic.
Method: We recruited patients hospitalized with COPD-E between 15 February and 15 December 2017 at Dept. Pulmonology, Semmelweis University, Budapest. Patients were free of exacerbation in prior 4 weeks, received max. 1 dose of systemic steroid before blood picture measures on admission. Patients were categorized into eosinophil positive (Eos+: ≥2% of leukocyte, N=33) and negative groups (Eos-: <2% of leukocyte, N=70). All patients were treated with systemic steroids during hospital stay. We analyzed data on medical history, blood C-reactive protein (CRP) concentration, spirometry, sputum culture results.
Results: No difference was found between patients with Eos+ and Eos- COPD-E in age, gender, length of COPD diagnosis, body mass index, pack-years, current smoking status, previous exacerbation history, FEV1 on admission, length of hospital stay and rate of positive bacteriological culture results of sputum. On admission there was a tendency for better FEV1/FVC (forced expiratory volume in the 1st second/forced vital capacity) (Eos+: 0.49 ± 0.09 vs. Eos-: 0.45 ± 0.09, mean ± SD, t-test: p=0.07) and lower CRP value in Eos+ patients (8.4 /2.4-18.9/ vs. 12.4 /4.3-44.5/ mg/L, median /interquartile range/, Mann-Whitney test: p=0.08). The improvement in FEV1 during hospital stay was higher in Eos+ patients (230 /60-600/ mL vs. 70 /-30-203/ mL, p=0.04).
Conclusion: COPD-E requiring hospitalizations and presenting with increased blood eosinophil percentage show a better lung function response to systemic steroid treatment and tend to have lower systemic inflammation. This implies the need for phenotype-specific therapy of COPD exacerbations.

Data of the presenter

Compulsory conference presentation as a grantee of the New National Excellence Program of the Ministry of Human Capacities (ÚNKP-17-4-III-SE-10).
E-mail address: lazar.zsofia@med.semmelweis-univ.hu