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No evidence for additional systemic eosinophil mobilization during exacerbations in patients with COPD and chronic bronchitis but no allergy

Year: 2025

Type: article

Abstract: Background: There is published evidence that a modest increase in blood eosinophils during stable COPD indicates future risk for exacerbations and a potential utility of inhaled corticosteroids. This has been perceived as an argument for targeting systemic eosinophil mobilization to prevent exacerbations in COPD, but there are no published data on systemic eosinophil mobilization during exacerbations in patients without allergy. Methods: = 10) during stable disease for cross-sectional comparisons. For longitudinal comparisons, we followed the COPD-CB group for 15 months during stable disease and exacerbations, excluding samples affected by systemic corticosteroids. We quantified blood concentrations of eosinophils, the activity marker eosinophilic cationic protein (ECP) and the chemokine interleukin (IL)-4. Results: During stable disease, the concentrations of eosinophils were similar for the COPD-CB and the LTS group, although higher than in the HNS group. The concentrations of ECP and IL-4 were not markedly different in the COPD-CB and LTS groups either. During exacerbations, the concentrations of eosinophils, ECP and IL-4 were not further increased, and there was even a mathematical trend towards a decrease for these concentrations. Conclusion: The clinical evidence presented here suggests that, by average, there is no additional mobilization of eosinophils during exacerbations in patients with COPD and chronic bronchitis but no allergy. Thus, in this common phenotype, the immunological rationale for targeting systemic eosinophils during exacerbations remains unaccounted for, which motivates verification studies in large cohorts stratified for allergy and chronic bronchitis.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1572291

Authors: Anders Andersson, Kristina Andelid, Bettina Brundin, Ann Ekberg-Jansson, Anders Lindén

Institutions: Sahlgrenska University Hospital, University of Gothenburg, Karolinska Institutet, Region Västra Götaland, Karolinska University Hospital

Language: English

Topic: Chronic Obstructive Pulmonary Disease (COPD) Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801