Reassessing the Role of Eosinophils as a Biomarker in Chronic Obstructive Pulmonary Disease.
COPD
eosinophil
exacerbations
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
02 Jul 2019
02 Jul 2019
Historique:
received:
30
05
2019
revised:
18
06
2019
accepted:
27
06
2019
entrez:
5
7
2019
pubmed:
5
7
2019
medline:
5
7
2019
Statut:
epublish
Résumé
Blood eosinophils measurement, as proxy for tissue eosinophils, has become an important biomarker for exacerbation risk and response to inhaled corticosteroids (ICS) in Chronic Obstructive Pulmonary Disease (COPD). Its use to determine the pharmacological approach is recommended in the latest COPD guidelines. The potential role of blood eosinophils is mainly based on data derived from post-hoc and retrospective analyses that showed an association between increased blood eosinophils and risk of exacerbations, as well as mitigation of this risk with ICS. Yet other publications, including studies in real life COPD, do not confirm these assumptions. Moreover, anti-eosinophil therapy targeting interleukin (IL)-5 failed to reduce exacerbations in COPD patients with high blood eosinophils, which casts significant doubts on the role of eosinophils in COPD. Furthermore, a reduction of eosinophils might be harmful since COPD patients with relatively high eosinophils have better pulmonary function, better life quality, less infections and longer survival. These effects are probably linked to the role of eosinophils in the immune response against pathogens. In conclusion, in COPD, high blood eosinophils are widely used as a biomarker for exacerbation risk and response to ICS. However, much is yet to be learned about the reasons for the high eosinophil counts, their variations and their controversial effects on the fate of COPD patients.
Identifiants
pubmed: 31269773
pii: jcm8070962
doi: 10.3390/jcm8070962
pmc: PMC6678852
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Subventions
Organisme : Università degli Studi di Padova
ID : SID 2018
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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