有慢性阻塞性肺疾病（COPD）和无COPD的吸烟者的血液嗜酸性粒细胞计数与小气道嗜酸性粒细胞之间的关联。
Association between blood eosinophil count and small airway eosinophils in smokers with and without COPD.
作者信息
Maetani Tomoki, Tanabe Naoya, Sato Atsuyasu, Shiraishi Yusuke, Sakamoto Ryo, Ogawa Emiko, Sakai Hiroaki, Matsumoto Hisako, Sato Susumu, Date Hiroshi, Hirai Toyohiro, Muro Shigeo
机构信息
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
出版信息
ERJ Open Res. 2023 Oct 2;9(5). doi: 10.1183/23120541.00235-2023. eCollection 2023 Sep.
INTRODUCTION
Airway eosinophilic inflammation is a pathological feature in a subgroup of patients with COPD and in some smokers with a high COPD risk. Although blood eosinophil count is used to define eosinophilic COPD, the association between blood eosinophil count and airway eosinophilic inflammation remains controversial. This cross-sectional study tested this association in smokers with and without COPD while considering potential confounders, such as smoking status and comorbidities.
METHODS
Lung specimens were obtained from smokers with and without COPD and non-COPD never-smokers undergoing lung lobectomy. Those with any asthma history were excluded. The infiltration of eosinophils into the small airway wall was quantified on histological sections stained with major basic protein (MBP).
RESULTS
The number of airway MBP-positive cells was greater in smokers (n=60) than in never-smokers (n=14). Smokers with and without COPD (n=30 each) exhibited significant associations between blood eosinophil count and airway MBP-positive cells (ρ=0.45 and 0.71). When smokers were divided into the high and low airway MBP groups based on their median value, blood eosinophil count was higher in the high-MBP group, with no difference in age, smoking status, comorbidities, emphysema or coronary artery calcification on computed tomography, and inhaled corticosteroid (ICS) use. The association between greater blood eosinophil count and the high-MBP group was confirmed in multivariable models adjusted for smoking status, airflow limitation and ICS use.
CONCLUSION
The blood eosinophil count may reflect eosinophilic inflammation in the small airways in smokers with and without COPD.
引言
气道嗜酸性粒细胞炎症是慢性阻塞性肺疾病（COPD）亚组患者以及一些具有高COPD风险吸烟者的病理特征。尽管血液嗜酸性粒细胞计数用于定义嗜酸性粒细胞性COPD，但血液嗜酸性粒细胞计数与气道嗜酸性粒细胞炎症之间的关联仍存在争议。这项横断面研究在有和没有COPD的吸烟者中测试了这种关联，同时考虑了潜在的混杂因素，如吸烟状态和合并症。
方法
从接受肺叶切除术的有和没有COPD的吸烟者以及非COPD从不吸烟者中获取肺标本。排除有任何哮喘病史的患者。在以主要碱性蛋白（MBP）染色的组织学切片上对嗜酸性粒细胞向小气道壁的浸润进行定量。
结果
吸烟者（n = 60）气道MBP阳性细胞数量比从不吸烟者（n = 14）更多。有和没有COPD的吸烟者（各n = 30）血液嗜酸性粒细胞计数与气道MBP阳性细胞之间均呈现显著关联（ρ = 0.45和0.71）。当根据中位数将吸烟者分为高气道MBP组和低气道MBP组时，高MBP组血液嗜酸性粒细胞计数更高，在年龄、吸烟状态、合并症、肺气肿或计算机断层扫描显示的冠状动脉钙化以及吸入糖皮质激素（ICS）使用方面无差异。在针对吸烟状态、气流受限和ICS使用进行调整的多变量模型中，证实了血液嗜酸性粒细胞计数较高与高MBP组之间的关联。
结论
血液嗜酸性粒细胞计数可能反映有和没有COPD的吸烟者小气道中的嗜酸性粒细胞炎症。
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