Abstract
BackgroundMeasurement of sputum is frequently used to define airway inflammatory subtypes. The venous blood cell is a reliable and simple biomarker, may be used as an alternative procedure to reflect the subtypes. For the aim of verifying the hypothesis that venous blood cell can quantify sputum inflammatory cell to access the airway subtypes in chronic obstructive pulmonary disease of acute exacerbations (AECOPD) and to ascertain the accuracy of the blood cell biomarker.MethodsThis study evaluated 287 patients with COPD exacerbations and all four tests were performed on the same day, which are lung function test, bronchodilator reversibility test, sputum cell analysis and blood routine examination.ResultsThere was a correlation between sputum eosinophils and blood eosinophils, blood cells derived ratios. There was a weaker relationship to neutrophils between sputum and blood. Sputum neutrophils had not any association with neutrophil/macrophage ratio (NMR) and eosinophil/lymphocyte ratio (ELR) in blood. Blood eosinophils percentage was predictive for eosinophilic COPD exacerbations with an area under the curve (AUC) of 0.672 (p = 0.012). The optimum cutpoint for blood eosinophils percentage was 0.55%. Blood eosinophils absolute count was also predictive sputum eosinophilia at 0.35 × 109/L (AUC = 0.626, p = 0.025). ELR, eosinophil/monocyte ratio (EMR) and eosinophil/neutrophil ratio (ENR) in blood were higher in COPD exacerbations with mixed granulocytic and eosinophilic subtypes.ConclusionEosinophils/neutrophils count parameters were relationship between blood and sputum. Eosinophils in blood and the ratios (ENR, EMR and ELR) may be utilized to assess eosinophilic airway inflammation in COPD exacerbations. Due to weak relationship and poor predictive ability, more researches should be required.
Highlights
Measurement of sputum is frequently used to define airway inflammatory subtypes
Characteristics of the patients We evaluated 287 patients with Chronic obstructive pulmonary disease (COPD) exacerbations who underwent lung function, sputum cells and blood samples
The blood eosinophil/lymphocyte ratio (ELR), eosinophil/neutrophil ratio (ENR) and eosinophil/monocyte ratio (EMR) were significantly higher in eosinophilic and mixed granulocytic group compared with other groups (Table 2, Fig. 1d-f)
Summary
Measurement of sputum is frequently used to define airway inflammatory subtypes. The venous blood cell is a reliable and simple biomarker, may be used as an alternative procedure to reflect the subtypes. For the aim of verifying the hypothesis that venous blood cell can quantify sputum inflammatory cell to access the airway subtypes in chronic obstructive pulmonary disease of acute exacerbations (AECOPD) and to ascertain the accuracy of the blood cell biomarker. Based on the percentage of eosinophils and neutrophils in sputum, it was to define four airway inflammatory subgroups: eosinophilic, neutrophilic, mixed granulocytic and paucigranulocytic [9]. Access to this test has a number of limitations, it is unsuitable for point-ofcare testing, it requires expertise and it may not be always successful. Very few studies have addressed the subgroups of airway inflammatory during clinical acute exacerbations
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