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Blood Eosinophil Count Stability in Chronic Obstructive Pulmonary Disease and the Eosinophilic Exacerbator Phenotype

Year: 2025

Type: article

Abstract: This longitudinal study from the EXCEL COPD cohort evaluated blood eosinophil count (BEC) stability and its relationship with exacerbations. Among 100 patients followed across four annual visits, 18% showed persistently high BEC (>300 cells/μl), 29% intermittent, and 53% never eosinophilic. A one-time BEC measurement missed up to 29% of persistently eosinophilic individuals. Patients with eosinophilic exacerbations had higher CAT scores (+2.8 points, P = 0.04) and a 60% increased annual exacerbation risk compared with noneosinophilic exacerbators. Findings highlight substantial intra-individual variability in BEC and identify an eosinophilic exacerbator phenotype potentially responsive to Th2-targeted therapies.

Source: American Journal of Respiratory and Critical Care Medicine