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Journals / Tüberküloz ve Toraks / 2020 / Cilt: 68 - Sayı: 3

A new predictor to determine the exacerbation and treatment of chronic obstructive pulmonary disease: eosinophil/neutrophil ratio

Kronik obstrüktif akciğer hastalığında alevlenmeyi ve tedavisini belirlemek için yeni bir belirteç: eozinofil/nötrofil oranı

Asiye KANBAY
Halil İbrahim YAKAR
Pages
260–267
Publication Date
2022-11-06
DOI
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Conclusion: Based on these findings, it is considered that more priority should be given to the use of ICS in COPD patients with high ENR and it can be used as a marker for predicting COPD exacerbation as COPD exacerbations are higher in patients with ENR.

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Objective & Hypothesis:A new predictor to determine the exacerbation and treatment of chronic obstructive pulmonary disease: eosinophil/neutrophil ratio Introduction: COPD is an inflammatory disease characterized by persistent respiratory symptoms and airflow limitation.
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Key Findings & Data:Currently, it has been demonstrated in some studies that eosinophil and T helper-2 mediated inflammation play a role in the pathophysiology of COPD.
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Conclusion & Impact:Conclusion: Based on these findings, it is considered that more priority should be given to the use of ICS in COPD patients with high ENR and it can be used as a marker for predicting COPD exacerbation as COPD exacerbations are higher in patients with ENR.
🔬Design:Research Article
📍Scope:2017 Verileri
⚙️Variables:Domain Parameters

Abstract

A new predictor to determine the exacerbation and treatment of chronic obstructive pulmonary disease: eosinophil/neutrophil ratio Introduction: COPD is an inflammatory disease characterized by persistent respiratory symptoms and airflow limitation. Currently, it has been demonstrated in some studies that eosinophil and T helper-2 mediated inflammation play a role in the pathophysiology of COPD. Materials and Methods: It was planned to evaluate eosinophilia, eosinophil/ neutrophil ratio (ENR), distribution of ENR according to GOLD groups, number of exacerbations in last year, relationship between ENR and the rate of ICS use in COPD patients, and the ENR cut-off value that predicts eosinophilic COPD. This study was planned prospectively in stable COPD patients between July 2017 and December 2017. All patients were divided into two groups as eosinophilic and non-eosinophilic group. Eosinophilia was considered to be > 2% of peripheric blood eosinophils. Results: A total of 206 stable COPD patients (127 eosinophilic and 79 noneosinophilic) were included. Age, gender, BMI, smoking history, mMrc score were statistically similar while average pack-year of smoking was significantly higher in eosinophilic group. ENR was significantly higher in eosinophilic group as expected (p< 0.001). High positive correlation was found between ENR and eosinophilic COPD (r= 0.8, p< 0.001). In Group D, the number of eosinophilic COPD patients is significantly higher than the non-eosinophilic group while the distribution of patients in group A, B, C was similar. Although the PFT findings were similar in both groups, the use of ICS was significantly lower and the number of exacerbations was significantly higher in eosinophilic group. In the ROC analysis, the ENR cut-off value that predicts eosinophilic COPD was found to be 0.32 in all COPD patients (Sens: 93.7%, Specif: 92.4%, AUC= 0.97, p< 0.001). Conclusion: Based on these findings, it is considered that more priority should be given to the use of ICS in COPD patients with high ENR and it can be used as a marker for predicting COPD exacerbation as COPD exacerbations are higher in patients with ENR.

Özet

Giriş: KOAH, kalıcı hava yolu kısıtlanması ve solunumsal semptomlar ile karakterize inflamatuar bir hastalıktır. Son zamanlarda eozinofil ve T helper-2 aracılı inflamasyonun KOAH patofizyolojisinde önemli rol oynadığı gösterilmiştir. Materyal ve Metod: Bu çalışmada stabil dönem KOAH’lılarda, eozinofili, eozinofil/nötrofil oranı (ENR), ENR’nin GOLD gruplarına göre dağılımı, son bir yıl içindeki alevlenme sayısı, ENR ve IKS kullanım oranı ilişkisi, eozinofilik KOAH alevlenmesini predikte eden ENR cut-off değerinin araştırılması planlandı. Bu çalışma, Temmuz 2017 ile Aralık 2017 arasında stabil KOAH hastalarında prospektif olarak planlandı. Tüm hastalar eozinofilik ve eozinofilik olmayan grup olmak üzere iki gruba ayrıldı. Eozinofili, periferik kan eozinofillerinin > %2’si olarak kabul edildi. Bulgular: Toplam 206 stabil KOAH hastası (127 eozinofilik ve 79 non-eozinofilik) çalışmaya dahil edildi. Gruplar arasında yaş, cinsiyet, VKİ, sigara öyküsü, mMrc skoru istatistiksel olarak benzer iken, eozinofilik grupta ortalama sigara paket yılı daha yüksek bulundu. ENR, eozinofilik grupta beklendiği gibi anlamlı yüksek bulundu (p< 0.001). ENR ve eozinofilik KOAH arasında pozitif korelasyon bulundu (r= 0.8, p< 0.001). Eozinofilik KOAH hastalarının sayısı D grubunda, non-eozinofilik gruptan anlamlı daha yüksek iken; A, B, C grubunda hastaların dağılımı benzer bulundu. Her iki grupta da SFT bulguları benzer olmasına rağmen, eozinofilik grupta ICS kullanımı anlamlı olarak daha düşük ve alevlenme sayısı anlamlı olarak daha yüksek bulundu. ROC analizinde eozinofilik KOAH’ı predikte eden ENR değeri 0.32 olarak bulundu (Sens: %93.7, Specif: %92.4, AUC= 0.97, p< 0.001). Sonuç: ENR’si yüksek KOAH hastalarında IKS kullanımına daha fazla öncelik verilmesi gerektiği düşünülmektedir. Ayrıca ENR’si yüksek hastalarda KOAH alevlenmelerinin daha sık olması nedeniyle KOAH alevlenmesini öngörmek için ENR’nin bir belirteç olarak kullanılabileceği düşünülmektedir

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Cite This Article

KANBAY, A., YAKAR, H. İ. (2022). A new predictor to determine the exacerbation and treatment of chronic obstructive pulmonary disease: eosinophil/neutrophil ratio. Tüberküloz ve Toraks, Cilt: 68 - Sayı: 3, 260–267. https://ajindex.com/articles/618359

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