Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
J Cyst Fibros. 2022 Nov;21(6):1048-1052. doi: 10.1016/j.jcf.2022.03.009. Epub 2022 Mar 31.
Elevated blood eosinophil counts are linked to worse outcomes in asthma and COPD, but have yet to be well characterized in CF. We hypothesized that higher stable visit blood eosinophil counts are associated with increased rates of lung function decline and pulmonary exacerbations (PEx).
We performed a retrospective analysis of adult CF patients (≥19 years) enrolled from 2012 to 2018 in a prospective cohort study focused on blood biomarkers. We included individuals with at least one year of follow-up post-stable visit blood draw and compared clinical characteristics by blood eosinophil count (<300 cells/µL vs. ≥300 cells/µL). We used multivariate mixed-effects linear regression to estimate annual change in ppFEV. Multivariable poisson and linear regression models were used to estimate rate of PEx requiring IV antibiotics and to compare CF Respiratory Symptom Diary-Chronic Respiratory Infection Symptom Scores (CFRSD-CRISS), respectively.
Of 109 patients, 17 (15.6%) had eosinophil counts ≥300 cells/µL. After adjustment for age, sex, BMI, and baseline ppFEV, there was no association between high vs. low eosinophil group and rates of lung function decline (difference in slope -0.04%/y; 95% CI -1.5 to +1.4) or rates of PEx requiring IV antibiotics (IRR 1.46; 95% CI 0.75 to 2.65). The high eosinophil group had a higher mean CFRSD-CRISS score at stable visit (adjusted mean difference 9.3; 95% CI 2.9 to 16.0).
The high eosinophil group experienced increased respiratory symptoms, but the rates of lung function decline and PEx were comparable between groups.
血液嗜酸性粒细胞计数升高与哮喘和 COPD 的预后不良有关，但在 CF 中尚未得到很好的描述。我们假设稳定就诊时较高的血液嗜酸性粒细胞计数与肺功能下降和肺部恶化（PEx）的发生率增加有关。
我们对 2012 年至 2018 年参加前瞻性队列研究的成年 CF 患者（≥19 岁）进行了回顾性分析，该研究重点关注血液生物标志物。我们纳入了至少有一年稳定就诊后血液采集随访的个体，并根据血液嗜酸性粒细胞计数（<300 个/µL 与≥300 个/µL）比较临床特征。我们使用多变量混合效应线性回归估计 ppFEV 的年变化。使用多变量泊松和线性回归模型分别估计需要 IV 抗生素的 PEx 发生率和比较 CF 呼吸症状日记-慢性呼吸道感染症状评分（CFRSD-CRISS）。
在 109 名患者中，有 17 名（15.6%）的嗜酸性粒细胞计数≥300 个/µL。调整年龄、性别、BMI 和基线 ppFEV 后，高与低嗜酸性粒细胞组之间的肺功能下降率（斜率差异-0.04%/y；95%CI-1.5 至+1.4）或需要 IV 抗生素的 PEx 发生率（IRR 1.46；95%CI 0.75 至 2.65）无相关性。高嗜酸性粒细胞组在稳定就诊时的 CFRSD-CRISS 评分平均值较高（调整后的平均差异 9.3；95%CI 2.9 至 16.0）。
高嗜酸性粒细胞组经历了更多的呼吸道症状，但两组之间的肺功能下降率和 PEx 发生率相当。
