Type 2 Inflammation in Eosinophilic Chronic Obstructive Pulmonary Disease (original) (raw)
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Eosinophilic airway inflammation in chronic obstructive pulmonary disease and asthma
Journal of physiology and pharmacology : an official journal of the Polish Physiological Society, 2008
Eosinophilic airway inflammation is regarded as a typical feature of asthma, while in chronic obstructive pulmonary disease (COPD) neutrophils seem predominant inflammatory airway cells. The aim of the present study was to compare the cellular components of airway inflammation in patients with newly diagnosed mild or moderate COPD and asthma. Seventeen patients with COPD (M/F 10/7, aged 57 +/-11 yr) and 22 patients with asthma (M/F 12/10, aged 36 +/-14 yr) were enrolled into the study. None of the patients has been treated with steroids for at least 3 months. All patients underwent clinical examination, laboratory examinations, skin-prick tests, pulmonary function tests, methacholine challenge test, and sputum induction with the total and differential cell count assessments. We found increased number of eosinophils in both study groups. However, there were no significant differences in the cellular composition of induced sputum between the asthma and COPD patients. We conclude that ...
Impact and associations of eosinophilic inflammation in COPD: analysis of the AERIS cohort
The European respiratory journal, 2017
Eosinophilic inflammation in chronic obstructive pulmonary disease (COPD) predicts response to treatment, especially corticosteroids. We studied the nature of eosinophilic inflammation in COPD prospectively to examine the stability of this phenotype and its dynamics across exacerbations, and its associations with clinical phenotype, exacerbations and infection.127 patients aged 40-85 years with moderate to very severe COPD underwent repeated blood and sputum sampling at stable visits and within 72 h of exacerbation for 1 year.Blood eosinophils ≥2% was prevalent at baseline, and predicted both predominantly raised stable-state eosinophils across the year (area under the curve 0.841, 95% CI 0.755-0.928) and increased risk of eosinophilic inflammation at exacerbation (OR 9.16; p<0.001). Eosinophils ≥2% at exacerbation and eosinophil predominance at stable visits were associated with a lower risk of bacterial presence at exacerbation (OR 0.49; p=0.049 and OR 0.25; p=0.065, respective...
Pakistan Journal of Medical and Health Sciences
Objective: To determine the frequency of eosinophilia in patients presenting with acute exacerbation chronic obstructive pulmonary disease (AECOPD). Patients and Methods: A total number 217 patients presenting with AECOPD were included from August-2021 to March-2022. Data regarding patients age, gender, diabetes, hypertension, smoking and duration of COPD was collected for each patient. After inclusion, venous blood samples were taken and were analyzed for presence of eosinophilia. Results: Mean age of patients was 59.32±8.92 years. Mean duration of COPD was 6.56±2.49 years. There were 127 (74.7%) male and 43 (25.3%) female patients. Out of 170, 121 (71.2%) patients were smokers, 66 (38.8%) diabetic and 79 (46.5%) hypertensive patients. Eosinophilia was diagnosed in 37 (21.8%) patients. Conclusion: Based on the data of our study including 170 patients hospitalized for AECOPD, we found that 21.8% patients had blood eosinophilia (defined as ≥300 cells/μL). So Peripheral blood eosinoph...
American Journal of Respiratory and Critical Care Medicine, 1994
Increasing evidence suggests an important role for cytokines in the regulation of eosinophilic inflammation.ln the present study we investigated the distribution of leukocytes,lymphocyte subsets, their activation state, and the cytokine profile present in BAL fluid from patients with various lung diseases associated with eosinophilia. For this purpose, we analyzed the levels of IL,113, IL-2,IL-4,IL-5,IL-6, IL-8, GM-CSF, TNF-ll, and IFN-y, as well as soluble IL-2 and TNF receptors, in concentrated bronchoalveolar lavage (BAL) fluid obtained from clearly defined patients with allergic and nonallergic asthma, eosinophilic pneumonia, allergic bronchopulmonary aspergillosis (ABPA), hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. BAL fluid from normal individuals and sarcoidosis patients was analyzed as noneosinophilic controls. BAL cytokine levels were compared with the cellular infiltrate and the activation state of CD4+ and CD8+ T cells as measured by the expression of IL-2 receptors (CD25), HLA-DR, and the very late activation antigen VLA-1. Beside the characteristic leukocyte infiltrate in the various lung diseases, all patients demonstrated significantly increased numbers of activated CD4 and CD8 T cells compared with normal individuals. The analysis of the cytokine profile present in BAL fluid revealed a T helper type 2 (Th2) cell cytokine pattern, with elevated IL-4 and IL-5 but normal levels of IL-2 or IFN-y in allergic asthma. ABPA patients demonstrated significantly increased levels of IL-4 and IL-5, with low but significantly elevated concentrations of IL-2 and IFN-y. In contrast, the analysis of the cytokine profile in sarcoidosis patients revealed a Th1 cell cytokine pattern characterized by increased concentrations of IL-2 and IFN-y but normal levels of IL-4 or IL-5. All other patient groups showed a cytokine pattern incompatible with a pure Th1 or Th2 cell response, because IL-5, IL-2, and IFN-y were found to be significantly increased. The BAL fluid analysis of the other, mainly non.:r cell-derived cytokines and soluble receptors showed increased levels in all patients compared with normal individuals and may represent the ongoing inflammatory responses. In conclusion, whereas increased IL-4levels were found only in diseases characterized by increased IgE production, IL-5 was elevated in all patients with increased numbers of eosinophils. The close correlation between IL-5levels, number of eosinophils, and activated T cells further supports a role for IL-5 in causing tissue eosinophilia.
Targeted therapy in eosinophilic chronic obstructive pulmonary disease
ERJ Open Research, 2021
Chronic obstructive pulmonary disease (COPD) is a common and preventable airway disease causing significant worldwide mortality and morbidity. Lifetime exposure to tobacco smoking and environmental particles are the two major risk factors. Over recent decades, COPD has become a growing public health problem with an increase in incidence. COPD is defined by airflow limitation due to airway inflammation and small airway remodelling coupled to parenchymal lung destruction. Most patients exhibit neutrophil-predominant airway inflammation combined with an increase in macrophages and CD8+ T-cells. Asthma is a heterogeneous chronic inflammatory airway disease. The most studied subtype is type 2 (T2) high eosinophilic asthma, for which there are an increasing number of biologic agents developed. However, both asthma and COPD are complex and share common pathophysiological mechanisms. They are known as overlapping syndromes as approximately 40% of patients with COPD present an eosinophilic a...
The Journal of allergy and clinical immunology, 2018
Eosinophilic airway inflammation in patients with chronic obstructive pulmonary disease (COPD) is associated with exacerbations and responsivity to steroids, suggesting potential shared mechanisms with eosinophilic asthma. However, there is no consistent blood eosinophil count that has been used to define the increased exacerbation risk. We sought to investigate blood eosinophil counts associated with exacerbation risk in patients with COPD. Blood eosinophil counts and exacerbation risk were analyzed in patients with moderate-to-severe COPD by using 2 independent studies of former and current smokers with longitudinal data. The Genetic Epidemiology of COPD (COPDGene) study was analyzed for discovery (n = 1,553), and the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study was analyzed for validation (n = 1,895). A subset of the ECLIPSE study subjects were used to assess the stability of blood eosinophil counts over time. COPD exacerbation risk...
Eosinophils, basophils and type 2 immune microenvironments in COPD-affected lung tissue
European Respiratory Journal, 2020
Although elevated blood or sputum eosinophils are present in many patients with COPD, uncertainties remain regarding the anatomical distribution pattern of lung-infiltrating eosinophils. Basophils have remained virtually unexplored in COPD. This study mapped tissue-infiltrating eosinophils, basophils and eosinophil-promoting immune mechanisms in COPD-affected lungs.Surgical lung tissue and biopsies from major anatomical compartments were obtained from COPD patients with severity grades Global Initiative for Chronic Obstructive Lung Disease stages I–IV; never-smokers/smokers served as controls. Automated immunohistochemistry and in situ hybridisation identified immune cells, the type 2 immunity marker GATA3 and eotaxins (CCL11, CCL24).Eosinophils and basophils were present in all anatomical compartments of COPD-affected lungs and increased significantly in very severe COPD. The eosinophilia was strikingly patchy, and focal eosinophil-rich microenvironments were spatially linked with ...
Eosinophilic Airway Diseases: From Pathophysiological Mechanisms to Clinical Practice
International Journal of Molecular Sciences
Eosinophils play a key role in airway inflammation in many diseases, such as allergic and non-allergic asthma, chronic rhinosinusitis with nasal polyps, and chronic obstructive pulmonary disease. In these chronic disabling conditions, eosinophils contribute to tissue damage, repair, remodeling, and disease persistence through the production a variety of mediators. With the introduction of biological drugs for the treatment of these respiratory diseases, the classification of patients based on clinical characteristics (phenotype) and pathobiological mechanisms (endotype) has become mandatory. This need is particularly evident in severe asthma, where, despite the great scientific efforts to understand the immunological pathways underlying clinical phenotypes, the identification of specific biomarkers defining endotypes or predicting pharmacological response remains unsatisfied. In addition, a significant heterogeneity also exists among patients with other airway diseases. In this revi...
Primary eosinophilic lung diseases
Allergy and Asthma Proceedings, 2013
Eosinophilic lung diseases typically present as a triad of pulmonary symptoms, an abnormal chest radiograph, and elevated levels of eosinophils in the sputum and lung tissue. This article focuses on primary causes of eosinophilic lung disease including acute eosinophilic pneumonia, chronic eosinophilic pneumonia, Churg-Strauss syndrome, and hypereosinophilic syndromes. In these disorders elevated eosinophil levels in the tissue lead to inflammation and tissue damage. Peripheral eosinophilia can often be measured when tissue levels are elevated but this is not as reliable a marker as tissue biopsy. Because corticosteroids act through a variety of mechanisms to inhibit eosinophil function and induce apoptosis, they are first-line therapy for eosinophilic lung diseases. Targeted immunosuppressive therapies, such as monoclonal antibodies against key regulatory cytokines for eosinophil production and survival, are not formally approved for eosinophilic lung disease but have shown promising results in published research studies.