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Obstructive Lung Diseases: COPD I |

Value of Sputum Eosinophilia in the Evaluation of Chronic Obstructive Pulmonary Diseases FREE TO VIEW

Fang Yi, MD; Jiaxing Xie, PhD; Wei Luo; Qiaoli Chen; KeFang Lai, PhD
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Guangzhou Institute of Respiratory Diseases, Guangzhou, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A368. doi:10.1016/j.chest.2016.02.383
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SESSION TITLE: COPD I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To investigate the value of sputum eosinophilia in evaluating disease severity of chronic obstructive disease (COPD).

METHODS: Patients with stable COPD were enrolled. Basic demographic data was recorded. We performed sputum induction, spirometry, 6 minutes walk test and detect pathogen of sputum and pharyngeal swab sample by RT-PCR method. All patients received 1 or 2 year fellow-up and regular treatments according to the GOLD guidelines.

RESULTS: 1. A total of 126 patients with stable COPD were enrolled. 2. Stable COPD: Sputum eosinophilia (≥2.5%) were observed in 56.3%, 52.7%, 49.5% in stable COPD at first, second and the third visit, respectively. The median level of sputum eosinophil were 5.4%, 5.6%, 5.3% at each follow-up respectively. A weak negative correlation between sputum eosinophil and FEV1% pred was found at every visit (rs1=−0.312, P<0.01, rs2=−0.222, P<0.05, rs3=−0.444, P<0.01 respectively). Sputum eosinophil of mild patients was significant lower than that of moderate to severe patients [1.7(0.7-4.0)% vs 2.5(0.8-4.6)%, 5.0(3.8-7.9)%, 5.7(1.5-8.3)%, P <0.01]. FEV1, FEV1% pred of patients with sputum eosinophilia decreased significantly. In addition, Borg scores of dyspnea and fatigue of patients with sputum eosinophilia were higher than those of patients without sputum eosinophilia. 3. Exacerbation: 49 patients experienced exacerbation. Sputum eosinophilia was found in 49.0% patients. Patients showed a trend of increased of sputum eosinophil at exacerbation [1.1(0.6-1.5)% vs 1.4(0.8-2.4)%]. Patients with sputum eosinophilia showed a trend of decreased of FEV1% pred, FEV1/FVC [58.2(33.2-73.1)% vs 63.6(43.2-68.8)%, 51.9(40.6-59.8)% vs 51.0(46.3-60.6)%]. A higher positive rate of PCR test for respiratory virus was found in patients with sputum eosinophilia when compared with patients without sputum eosinophilia (62.5% vs 28%, P<0.01). The most common virus were rhinovirus. The level of sputum eosinophil of patients with viral infection was significantly higher than that of patients without viral infection [3.4(2.1-6.3)% vs 1.7(0.8-2.9)%, P<0.05].

CONCLUSIONS: 1. Nearly 50% patients with COPD showed sputum eosinophilia in stable condition or exacerbation. 2. COPD patients with eosinophilia had more severe airway obstruction, dyspnea and bad physical endurance. 3. Increased sputum eosinophil in patients with viral infection during AECOPD.

CLINICAL IMPLICATIONS: Sputum eosinophil can be regarded as a biomarker in evaluation of the disease severity of COPD.

DISCLOSURE: The following authors have nothing to disclose: Fang Yi, Jiaxing Xie, Wei Luo, Qiaoli Chen, KeFang Lai

No Product/Research Disclosure Information


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