Matucci Andrea, Vivarelli Emanuele, Perlato Margherita, Mecheri Valentina, Accinno Matteo, Cosmi Lorenzo, Parronchi Paola, Rossi Oliviero, Vultaggio Alessandra
Immunoallergology Unit, Careggi University Hospital, 50134 Florence, Italy.
Department of Clinical and Experimental Medicine, Unit of Internal Medicine, University of Florence, 50121 Florence, Italy.
Biomedicines. 2022 Oct 24;10(11):2688. doi: 10.3390/biomedicines10112688.
Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a small-vessel necrotizing vasculitis with multiple organ involvement. Despite improvements in clinical management, biomarkers for organ involvement and disease prognosis are still an unmet need. Methods: EGPA patients referred to our immunology clinic were retrospectively reviewed. Demographic/clinical features, eosinophils, ANCA status, eosinophil cationic protein (ECP) and total serum IgE were evaluated at the baseline. Eosinophils, total serum IgE, ECP and ANCA were studied as possible biomarkers for lung and extrapulmonary disease. Results: In total, 167 EGPA patients were recruited for our study. A positive association between eosinophils and peripheral nervous system (PNS) involvement was demonstrated (p <0.001; chi-squared test). Receiver operating characteristic (ROC) curves using the eosinophil count or percentage as predictors of PNS involvement yielded AUC values of 0.75 and 0.67, respectively. ANCA positivity was associated with PNS involvement, while no correlations with clinical parameters were found for ECP and total serum IgE. Patients without extrapulmonary involvement had lower eosinophils (eosinophils: 2844.7 ± 1698 vs. 6373 ± 5468, p < 0.001; eosinophil percentage: 24.6 ± 10% vs. 36.2 ± 15.8, p < 0.001) and were less likely to be ANCA+ (p < 0.001, chi-squared test). Conclusion: Eosinophils in EGPA are an important biomarker and are associated with extrapulmonary involvement. These findings could strengthen the role of anti-eosinophilic drugs in improving extrapulmonary disease.
嗜酸性肉芽肿性多血管炎（EGPA）是一种累及多器官的小血管坏死性血管炎。尽管临床管理有所改善，但用于评估器官受累情况和疾病预后的生物标志物仍未得到满足。方法：对转诊至我们免疫科门诊的EGPA患者进行回顾性研究。在基线时评估患者的人口统计学/临床特征、嗜酸性粒细胞、抗中性粒细胞胞浆抗体（ANCA）状态、嗜酸性粒细胞阳离子蛋白（ECP）和总血清IgE。研究嗜酸性粒细胞、总血清IgE、ECP和ANCA作为肺部和肺外疾病可能生物标志物的情况。结果：本研究共纳入167例EGPA患者。嗜酸性粒细胞与外周神经系统（PNS）受累之间存在正相关（p<0.001；卡方检验）。以嗜酸性粒细胞计数或百分比作为PNS受累预测指标的受试者工作特征（ROC）曲线，其曲线下面积（AUC）值分别为0.75和0.67。ANCA阳性与PNS受累相关，而未发现ECP和总血清IgE与临床参数之间存在相关性。无肺外受累的患者嗜酸性粒细胞水平较低（嗜酸性粒细胞：2844.7±1698 vs. 6373±5468，p<0.001；嗜酸性粒细胞百分比：24.6±10% vs. 36.2±15.8，p<0.从01），且ANCA阳性的可能性较小（p<0.001，卡方检验）。结论：EGPA中的嗜酸性粒细胞是一种重要生物标志物，与肺外受累相关。这些发现可能会加强抗嗜酸性粒细胞药物在改善肺外疾病方面的作用。
