5th Pulmonary Department, "Sotiria" Chest Diseases Hospital, Athens, Greece.
1st Respiratory Medicine Department, University of Athens Medical School Sotiria' Chest Hospital,'Athens, Greece.
Expert Rev Respir Med. 2022 Jan;16(1):35-41. doi: 10.1080/17476348.2021.2011219. Epub 2021 Dec 3.
The pathogenesis of chronic obstructive pulmonary disease (COPD) is highly complex and the underlying cellular and molecular mechanisms remain poorly understood.
COPD has been traditionally associated with neutrophilic inflammation of the bronchi, but in the last decade, studies have demonstrated that eosinophils may also migrate into the lower airways of patients with COPD and their increased numbers can be noticed during exacerbations as well as stable disease. In this review, we present clinical characteristics of eosinophilic COPD, as well as the role of eosinophils as a biomarker-guided therapy in COPD. A systematic research using the database of Pubmed up to February 2021 was performed. The terms we searched were eosinophilic inflammation, COPD, COPD phenotypes, COPD exacerbations, corticosteroids in COPD, and monoclonal antibodies in COPD.
Blood eosinophil levels show strong potential as a prognostic and theragnostic biomarker in the clinical management of COPD being at the moment the most reliable biomarker. The lack of a certain cutoff value of blood eosinophils as guidance for treatment with ICS and biologic therapies and the uncertainty regarding the stability of eosinophilia and eosinophilic phenotype through the course of COPD remain as unmet dilemmas and problems.
慢性阻塞性肺疾病（COPD）的发病机制非常复杂，其潜在的细胞和分子机制仍知之甚少。
COPD 传统上与支气管中性粒细胞炎症有关，但在过去十年中，研究表明嗜酸性粒细胞也可能迁移到 COPD 患者的下气道，并且在加重期和稳定期都可以注意到它们数量的增加。在这篇综述中，我们介绍了嗜酸性 COPD 的临床特征，以及嗜酸性粒细胞作为 COPD 生物标志物指导治疗的作用。使用 Pubmed 数据库进行了截至 2021 年 2 月的系统研究。我们搜索的术语是嗜酸性炎症、COPD、COPD 表型、COPD 加重、COPD 中的皮质类固醇和 COPD 中的单克隆抗体。
血液嗜酸性粒细胞水平作为 COPD 临床管理的预后和治疗生物标志物具有很强的潜力，目前是最可靠的生物标志物。缺乏用于 ICS 和生物治疗的治疗指导的血液嗜酸性粒细胞的特定截止值，以及在 COPD 病程中嗜酸性粒细胞和嗜酸性表型的稳定性存在不确定性，这些都是未满足的困境和问题。
