Details

Autor(en) / Beteiligte

• Shoemark, Amelia
• Shteinberg, Michal
• De Soyza, Anthony
• Haworth, Charles S
• Richardson, Hollian
• Gao, Yonghua
• Perea, Lidia
• Dicker, Alison J
• Goeminne, Pieter C
• Cant, Erin
• Polverino, Eva
• Altenburg, Josje
• Keir, Holly R
• Loebinger, Michael R
• Blasi, Francesco
• Welte, Tobias
• Sibila, Oriol
• Aliberti, Stefano
• Chalmers, James D

Titel

Characterization of Eosinophilic Bronchiectasis: A European Multicohort Study

Ist Teil von

• American journal of respiratory and critical care medicine, 2022-04, Vol.205 (8), p.894-902

Ort / Verlag

United States: American Thoracic Society

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Bronchiectasis is classically considered a neutrophilic disorder, but eosinophilic subtypes have recently been described. To use multiple datasets available through the European Multicentre Bronchiectasis Audit and Research Collaboration to characterize eosinophilic bronchiectasis as a clinical entity focusing on the impact of eosinophils on bronchiectasis exacerbations. Patients were included from five countries to examine the relationships between blood eosinophil counts and clinical phenotypes after excluding coexisting asthma. 16S rRNA sequencing was used to examine relationships between eosinophil counts and the sputum microbiome. A analysis of the PROMIS (Inhaled Promixin in the Treatment of Non-Cystic Fibrosis Bronchiectasis) phase 2 trial was used to examine the impact of blood eosinophil counts on exacerbations in patients with infection. A relationship between sputum and blood eosinophil counts was demonstrated in two cohorts. In analysis of 1,007 patients from five countries, 22.6% of patients had blood eosinophil counts of ⩾300 cells/μl. Counts of <100 cells/μl were associated with higher bronchiectasis severity and increased mortality. There was no clear relationship with exacerbations. Blood eosinophil counts of ⩾300 cells/μl were associated with both - and -dominated microbiome profiles. To investigate the relationship of eosinophil counts with exacerbations after controlling for the confounding effects of infection, 144 patients were studied in a clinical trial after treatment with antipseudomonal antibiotics. Compared with patients with blood eosinophil counts of <100 cells/μl (reference), elevated eosinophil counts of 100-299 cells/μl (hazard ratio, 2.38; 95% confidence interval, 1.33-4.25;  = 0.003) and ⩾300 cells/μl (hazard ratio, 3.99; 95% confidence interval, 2.20-7.85;  < 0.0001) were associated with shorter time to exacerbation. Eosinophilic bronchiectasis affects approximately 20% of patients. After accounting for infection status, raised blood eosinophil counts are associated with shortened time to exacerbation.