Blood Eosinophils In Patients Research Articles

Blood eosinophilia in patients with severe bronchial asthma and chronic polypous rhinosinusitis treated with dupilumab: A review

Bronchial asthma and chronic polypous rhinosinusitis are diseases associated with a T2-inflammatory immune response. These nosologies can be combined, creating the preconditions for a more severe course of multimorbidity, requiring the use of genetic engineering biological therapy. Dupilumab is a monoclonal antibody that can specifically bind to the alpha subunit of the interleukin-4 receptor and block the action of interleukins 4 and 13, which play a key role in the development of T2 inflammation. Numerous studies have demonstrated the high effectiveness of this medicament. The use of dupilumab in some cases may be accompanied by an increase in eosinophils in the blood. This article presents scientific base and our own experience in treating patients with dupilumab-associated eosinophilia, in addition we describe an algorithm for examining this group of patients for the purpose of timely diagnosis of diseases such as eosinophilic granulomatosis with polyangiitis, eosinophilic pneumonia, etc. It should be noted that in the most cases eosinophilia during targeted therapy with dupilumab is temporary and does not cause clinical manifestations.

Peripheral Blood Eosinophilia in Patients with Diabetic Foot Infection Receiving Long-Term Antibiotic Therapy.

Background: The eosinophil level in peripheral blood increases in response to various conditions, the most common being medication use. Since the outcome of increased levels of eosinophils can range from a benign finding to extensive damage to host organs and systemic consequences, this finding raises concern among clinicians. We aimed to assess the prevalence of prolonged antibiotic-therapy-induced eosinophilia and possible outcomes. Methods: We conducted a retrospective cohort study of diabetic patients admitted to the orthopedic department from December 2016 through December 2020 due to a moderate to severe diabetic foot infection and who received at least 14 days of antibiotic therapy. Patients were identified retrospectively through the orthopedic department registry, and their files were reviewed, extracting demographics, laboratory test results, antibiotic treatment, and outcomes. Results: The cohort included 347 patients; a total of 114 (32.8%) developed eosinophilia during the follow-up period. Patients who developed eosinophilia had a significantly longer duration of antibiotic treatment (p < 0.001) and a significantly longer hospitalization (p = 0.001). For multivariable analysis, the independent risk factors predicting drug-induced eosinophilia included older age, higher eosinophil count on admission (per quantile) and higher platelet count on admission (per quantile) (p = 0.012, p < 0.001, p = 0.009, respectively). There was no evidence of complications in patients who developed eosinophilia compared to patients who did not. No significant association with a specific type of antibiotic was found. Conclusions: We found a higher incidence of drug-induced eosinophilia than expected or previously described. The factors associated with eosinophilia included age and higher baseline eosinophil and platelet levels but not antibiotic type.

The Association of Vitamin D Receptor Gene Polymorphisms with Vitamin D, Total IgE, and Blood Eosinophils in Patients with Atopy.

In order to improve the control of atopic diseases, it is important to clarify the pathogenesis of atopy and identify its various triggers. Single nucleotide polymorphisms (SNPs) of the vitamin D receptor gene (VDR) may impact atopy. The aim of this study was to investigate the possible associations between VDR SNPs and vitamin D, total IgE, and eosinophils in atopy. In total, 203 adults, including 122 patients with atopic diseases (45 with atopic dermatitis, 77 with allergic asthma) and 81 healthy controls, were involved in the study. The blood eosinophil count was determined with an automated hematology analyzer. Vitamin D and total immunoglobulin E (IgE) levels were evaluated using the ELISA method. Polymorphisms in the VDR gene were analyzed with real-time PCR using TaqMan probes. We analyzed six VDR single nucleotide polymorphisms and found a significant association between VDR rs731236 GG genotype and normal vitamin D levels in atopic patients and healthy subjects (OR 11.33; 95% CI: 1.049-122.388 and OR 4.04; 95% CI: 1.117-14.588, respectively, p < 0.05). Additionally, the study results revealed a significant relationship between the VDR rs2228570 GG genotype and normal vitamin D levels in patients with atopy and healthy subjects (OR 3.80; 95% CI: 1.190-12.134 and OR 2.09; 95% CI: 1.044-4.194, respectively, p < 0.05). The rs2228570 allele A was associated with decreased vitamin D levels in patients with atopy and healthy subjects (OR 0.28; 95% CI: 0.098-0.804 and OR 0.229; 95% CI: 0.069-0.761, respectively, p < 0.05). The VDR rs3847987 genotypes AA and AC were significantly associated with normal vitamin D levels in healthy subjects (OR 35.99; 95% CI: 6.401-202.446 and OR 4.72; 95% CI: 1.489-15.007, respectively, p < 0.05). In addition, a decreased amount of vitamin D was associated with atopic diseases such as atopic dermatitis and allergic asthma (OR 0.49; 95% CI: 0.439-1.308 and OR 0.58; 95% CI: 0.372-0.908, respectively, p < 0.05). The rs11168293 allele T was associated with the normal range of total IgE in atopy (OR 2.366; 95% CI: 1.133-5.027; p < 0.05). Significant associations were found between VDR rs731263 allele G, rs11168293 allele G, and increased blood eosinophil levels in patients with atopy (OR 0.319; 95% CI: 0.163-0.934 and OR 0.323; 95% CI: 0.112-0.935, respectively, p < 0.05). A decreased vitamin D level showed a significant relationship with atopic diseases (atopic dermatitis and allergic asthma). The association between the VDR gene polymorphisms rs2228570, rs731236, and rs11168293 and vitamin D, total IgE, and blood eosinophils in patients with atopy suggested that VDR polymorphisms and the vitamin D level should be considered when examining the factors associated with atopy.

Markers of eosinophilic airway inflammation in patients with asthma and allergic rhinitis.

Background: Measurement of airway inflammation is an important step to determine phenotype of asthma and allergic rhinitis (AR). Objective: To assess the level of nitric oxide in exhaled air (FeNO), nasal fraction of nitric oxide (nasal NO), their relationship with clinical control and blood eosinophils in patients with steroid-naive mild and moderate asthma and AR. Methods: One hundred forty-seven patients (65 men), ages 26-49.5 years (mean age, 32 years) with AR (n = 81) or AR and concomitant asthma (n = 46) and 20 healthy subjects were included in a single-center cohort study. All the patients underwent spirometry with reversibility test. Control of asthma and AR was assessed by using the Asthma Control Questionnaire and the visual analog scale, respectively. Levels of FeNO and nasal NO were measured by chemiluminescent analyzer, peripheral blood eosinophils were counted by automatic analyzer. Results: The FeNO level was significantly elevated in the patients with asthma and concomitant AR compared with the healthy subjects and was associated with control of both asthma and AR. There was no correlation between nasal NO and control of AR. Receiver operating characteristic analysis revealed that the level of eosinophils of 150 cells/μL may be a cutoff for lower airway eosinophilic inflammation. Blood eosinophils count was unable to distinguish eosinophilic and non-eosinophilic upper airway inflammation. Conclusion: We confirm that FeNO but not nasal NO is a marker of eosinophilic airway inflammation in patients with mild-moderate steroid-naive AR and concomitant asthma. A blood eosinophil level of ≥150 cells/µL may be a simple marker of eosinophilic airway inflammation in patients with asthma. However, its low specificity requires repeated measurements and use in combination with other biomarkers.

Temporal trends of blood eosinophilia in severe uncontrolled CRSwNP treated with dupilumab: a real-life study.

Induced eosinophilia is commonly related to dupilumab treatment. We analysed the temporal trends of blood eosinophilia in patients with severe uncontrolled CRSwNP during the first year of treatment with dupilumab in real-life setting to evaluate its correlation with outcomes of response and adverse events (AEs). Seventy-four patients with severe uncontrolled CRSwNP treated with dupilumab at our institution were enrolled. At each visit, we evaluated AEC, outcomes of response to treatment and AEs. A significant increase in AEC was observed since the first month with a peak at 3 months; at 12 months, the values returned comparable to those at baseline. A ≥ 50% increase of the baseline AEC with a value greater than 500 cells/mm3 was documented in 38/74 patients (Group A) regardless of the time of observation, whereas in 36/74 patients (Group B), no changes were observed. Analysing the blood eosinophilia trend over time in group A, we observed a temporary eosinophilia with early onset (within 6 months), persistent eosinophilia with early onset, and eosinophilia with late onset. No differences in terms of outcomes of response to treatment or AEs were found between Group A and Group B, or between patients who developed an AEC ≥ 1500 cells/mm3 or not. In our series, we observed that an increase in AEC with different temporal trends may be observed in CRSwNP patients during the first year of treatment with dupilumab. In our series, eosinophilia is not correlated with a negative outcome of response to treatment or a risk of AEs.

Demonstration of tissue and peripheral blood eosinophils in patients with acute appendicitis

Demonstration of tissue and peripheral blood eosinophils in patients with acute appendicitis

Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pul- monary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil-lymphocyte ratio and peripheral blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary diseases. This would reduce the rate of re-hospitalization in 28 days. Patients were hospitalized due to acute exacerbation of chronic obstructive pulmonary diseases from February 1, 2018, to January 31, 2019. Patients were divided into 2 groups: Sureyyapasa protocol group and conventional group. In the Sureyyapasa protocol group, patients were divided into 4 subgroups according to peripheral blood eosinophilia and neutrophil-lympho- cyte ratio values. Treatment success was defined as 5-7 days acute exacerbation of chronic obstructive pulmonary diseases treatment was enough to discharge and no re-hospitalization within 28 days. Treatment failure was defined that the hospital stay was longer than 7 days or transport to intensive care and death or readmission to the hospital due to acute exacerbation of chronic obstructive pulmonary diseases within 28 days after discharge. The Sureyyapasa protocol group (n = 96) and the conventional group (n = 95) were randomly selected. The conventional group and Sureyyapasa protocol group had similar hospital stay (P = .22), and antibiotic and steroid uses were significantly higher in the conventional group than the Sureyyapasa protocol group (antibiotic use 100% vs. 83%, P < .001 and steroid use 84% vs. 29%, P < .001, respectively). Treatment failure in the conventional Group (n = 23, 24%) is higher than the Sureyyapasa protocol group (n = 17, 18%). Initiating treatment by evaluating eosinophilia and neutrophil-lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary diseases in the ward reduces unnecessary antibiotic and steroid use and cost rates in hospitalizations.

Blood Eosinophils and Clinical Outcomes in Inpatients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study.

The prognostic value of blood eosinophils in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains controversial. This study aimed to evaluate whether blood eosinophils could predict in-hospital mortality and other adverse outcomes in inpatients with AECOPD. The patients hospitalized for AECOPD were prospectively enrolled from ten medical centers in China. Peripheral blood eosinophils were detected on admission, and the patients were divided into eosinophilic and non-eosinophilic groups with 2% as the cutoff value. The primary outcome was all-cause in-hospital mortality. A total of 12,831 AECOPD inpatients were included. The non-eosinophilic group was associated with higher in-hospital mortality than the eosinophilic group in the overall cohort (1.8% vs 0.7%, P < 0.001), the subgroup with pneumonia (2.3% vs 0.9%, P = 0.016) or with respiratory failure (2.2% vs 1.1%, P = 0.009), but not in the subgroup with ICU admission (8.4% vs 4.5%, P = 0.080). The lack of association still remained even after adjusting for confounding factors in subgroup with ICU admission. Being consistent across the overall cohort and all subgroups, non-eosinophilic AECOPD was also related to greater rates of invasive mechanical ventilation (4.3% vs 1.3%, P < 0.001), ICU admission (8.9% vs 4.2%, P < 0.001), and, unexpectedly, systemic corticosteroid usage (45.3% vs 31.7%, P < 0.001). Non-eosinophilic AECOPD was associated with longer hospital stay in the overall cohort and subgroup with respiratory failure (both P < 0.001) but not in those with pneumonia (P = 0.341) or ICU admission (P = 0.934). Peripheral blood eosinophils on admission may be used as an effective biomarker to predict in-hospital mortality in most AECOPD inpatients, but not in patients admitted into ICU. Eosinophil-guided corticosteroid therapy should be further studied to better guide the administration of corticosteroids in clinical practice.

Stability of Blood Eosinophils in COPD with Multiple Acute Exacerbations Within 1 Year and Its Relationship with Prognosis.

The relationship between increased blood eosinophils (EOS) and the prognosis of patients with chronic obstructive pulmonary disease (COPD) remains controversial. We aimed to explore the stability of blood eosinophils in patients with multiple hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) over a 1-year period and its relationship with readmission rates and mortality. Prospectively include patients with at least 2 hospitalizations for AECOPD in 1 year between June 2019 and December 2021. Using 150 cells/ul as the cut-off value, the study population was divided into EOS, non-EOS, and fluctuating groups based on the longitudinal stability of blood EOS. The relationship between blood EOS and readmission rate and mortality was analyzed according to the 6-month follow-up after hospital discharge. A total of 202 patients were included. 48, 108, and 46 patients were in the EOS, non-EOS, and fluctuating groups, respectively. The stability of blood EOS at 1 year was 77.2%. The risk of death was lower in the EOS group compared to the non-EOS group (HR=0.323, 95% CI 0.113-0.930, P =0.036). The risk of readmission was lower in both the EOS group (HR=0.486, 95% CI 0.256-0.923, P =0.027) and the non-EOS group (HR=0.575, 95% CI 0.347-0.954, P = 0.032) than in the fluctuating group. The blood EOS of COPD patients is relatively stable over 1 year. Patients with consistently high blood EOS had a lower risk of all-cause mortality after discharge; patients with fluctuating blood EOS had a higher risk of readmission.

Frequency of Blood Eosinophilia in Patients of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)

Objective: To determine the frequency of eosinophilia in patients presenting with acute exacerbation chronic obstructive pulmonary disease (AECOPD). Patients and Methods: A total number 217 patients presenting with AECOPD were included from August-2021 to March-2022. Data regarding patients age, gender, diabetes, hypertension, smoking and duration of COPD was collected for each patient. After inclusion, venous blood samples were taken and were analyzed for presence of eosinophilia. Results: Mean age of patients was 59.32±8.92 years. Mean duration of COPD was 6.56±2.49 years. There were 127 (74.7%) male and 43 (25.3%) female patients. Out of 170, 121 (71.2%) patients were smokers, 66 (38.8%) diabetic and 79 (46.5%) hypertensive patients. Eosinophilia was diagnosed in 37 (21.8%) patients. Conclusion: Based on the data of our study including 170 patients hospitalized for AECOPD, we found that 21.8% patients had blood eosinophilia (defined as ≥300 cells/μL). So Peripheral blood eosinophilia can be used a significant biomarker in patients with acute exacerbation of COPD. Keywords: Acute exacerbation, Eosinophilia, chronic obstructive pulmonary disease.

Dependence of thymic stromal lymphopoietin serum concentration from bronchial asthma control level and lung function results in patients of different age groups

Introduction. Bronchial asthma (BA) pathogenesis is settled by bronchial wall inflammation, which is the main treatment target.Aim. To study the dependence of thymic stromal lymphopoietin (TSLP) concentration in serum and nasal brush-biopsies from age, spirometry data deterioration and blood eosinophils in patients with uncontrolled BA.Materials and methods. Patients with uncontrolled BA of three age groups: children (6–11 y.o., n = 38), adolescents (14–17 y.o., n = 35) and adults (25–50 y.o., n = 31) were included in 1-year long open prospective study. Clinical history, АСТ/сАСТ questionnaires, lung function test (LFT), common blood count, serum and nasal material to evaluate TSLP were obtained during first visit, if there were no any signs of acute respiratory infection for not less than 14 days. Maintenance therapy was revised based on firstvisit findings. Patient were consequently examined twice with 6 months intervals, examination data, LFT readings, ACT results and eosinophil counts were collected. Statistical analyses included ANOVA (Kruskal-Wallis test) and Pearson’s correlation (r). Differences accepted significant with р &lt; 0,05.Results. Serum TSLP levels did not differ between age groups. TSLP concentration correlate directly and significantly with duration of uncontrolled BA in previous 12 months (r = 0.74). In patients with atopic BA, maximum TSLP level was in dust mites sensitized group (792.6 ± 114.1 pg/ml). We have found greater serum TSLP concentration in patients who demonstrated FEV1 below normal even on optimal controller therapy at Visit 3. Eosinophil count randomly changed inside normal values and did not correlate with asthma control or TSLP level.Conclusion. Prognosis of future asthma exacerbations and LFT decrease is less favourable in patients with high serum TSLP level.

The levels and correlations of FeNO, blood eosinophils and lung function in well-controlled asthma.

Whether biomarkers (i.e., fractional exhaled nitric oxide (FeNO) and blood eosinophils) or lung function are additional ultimate outcomes in asthma treatment among patients with clinical remission has been the subject of previous research, the study of the correlations between FeNO, blood eosinophils and lung function among well-controlled asthmatic patients is less clear. To investigate the clinical application of the correlation between FeNO, blood eosinophils and lung function parameters in well-controlled asthmatic patients. This was a prospective cross-sectional study. We measured FeNO, blood eosinophil and lung function in 84 asthmatic patients with clinical remission who were assessed by asthma control questionnaires. The correlation coefficient was used to ascertain among those parameters. The diagnostic accuracy of blood eosinophil to identify low FeNO (< 25 ppb) was calculated using the area under the receiver operating characteristics (AUROC). Of 84 patients analyzed, the median ACT was 25 and the median ACQ-7 was 0.43. The median duration of being well-controlled asthma was 14.5 months. The median FeNo was 23 ppb and the median blood eosinophils was 375 cell/mm³. A significant positive correlation was found between FeNo and blood eosinophil (r = 0.310, p = 0.004). No correlation was detected between either FeNO or blood eosinophil and all lung function parameters. The AUROC results for blood eosinophils was 64.4% (p = 0.024) to detect FeNO < 25 ppb at a cutoff point of 295 cell/mm3 (sens tivity = 83.5%, specificity = 50%). Measuring FeNO and blood eosinophils in patients with a clinical remission of asthma may determine which of those patients have achieved complete remission. As the level of blood eosinophils has a significant correlation with FeNO, it may easily be a feasible biomarker to evaluate inactive airway inflammation before stepping down asthma treatment.

Influence of Broncho-Vaxom Immunotherapy Combined with Trelegy Ellipta on Blood Eosinophils in Patients with Chronic Obstructive Pulmonary Disease

Influence of Broncho-Vaxom Immunotherapy Combined with Trelegy Ellipta on Blood Eosinophils in Patients with Chronic Obstructive Pulmonary Disease

Eosinophilia in Patients with End Stage Renal Disease Undergoing Hemodialysis

Objective: Eosinophilia in patients on hemodialysis has already been reported. It has been associated with allergy to dialyzers and exaggerated activation of complement during hemodialysis. Its etiology, however, remains unknown. In addition, there are not enough studies on eosinophilia in patients on hemodialysis in Korea. Therefore, we performed this retrospective study to find out the prevalence and possible etiologic factors of blood eosinophilia in patients undergoing hemodialysis.Methods: Between January 2013 to December 2015, the patients hospitalized for hemodialysis at Soonchunhyang University Hospital and National Health Insurance Service Medical Center (Ilsan Hospital) were included in this study. Eosinophilia was defined when absolute eosinophil count was greater than 500/μL, respectively. We retrospectively reviewed the medical records of patients about parasite infection, other malignancies, and history of kidney transplantation.Results: Of the 2,155 patients hospitalized for hemodialysis at two centers, 1,057 patients (49%) were found to have eosinophilia. We investigated 1,199 patients’ information (Soonchunhyang University Hospital) by the medical records. Two hundred two patients (16.8%) had no identifiable and/or possible causes. Only two patients complained of symptoms such as itching. Steroids were administered to control symptoms, and both patients had normal eosinophil levels, and steroids were discontinued. Other patients did not complain of specific symptoms associated with eosinophilia and did not take medication such as steroids. Eosinophilia was improved in 49% of patients without special treatments.Conclusion: We found that the eosinophil counts in patients with end stage renal disease on hemodialysis were frequently elevated. However, in most cases, eosinophilia was not clinically relevant.

The Benefit of Benralizumab Monoclonal Antibody Treatment for Severe Eosinophilic Asthma in a Case Series (Pulmonology Clinic Târgu Mureș, Romania)

Abstract Background: Monoclonal antibody therapy is currently an additional treatment option to reduce exacerbations and improve symptom control in patients with severe eosinophilic asthma (SEA) that is uncontrolled despite treatment with high-dose inhaled corticosteroids and long-acting beta-2 agonists. Benralizumab, a monoclonal antibody that binds to the interleukin-5 receptor (IL-5), significantly reduces symptoms and annual exacerbations, as well as the use of systemic corticosteroids in patients with SEA. However, few studies are available on the effectiveness of this biological treatment in real life. The aim of this case series was to evaluate the efficacy of benralizumab by analyzing changes in clinical parameters and blood eosinophils in patients with SEA. Methods: We analyzed four patients with SEA who started treatment with benralizumab. The history of symptoms and exacerbations, eosinophil counts, data regarding the oral corticosteroid dose, need for rescue treatment, spirometry measurements and asthma control questionnaires (ACT) regarding the level of asthma control were recorded. A positive response to treatment was defined by a significant reduction in eosinophil counts, increased ACT scores, and lower rates of exacerbations. Results and conclusions: Benralizumab monoclonal antibody was effective in all four patients. This was shown by a reduction in exacerbation rates, symptom severity, and lower dose of oral corticosteroids and rescue medication. This novel treatment was well tolerated by the analyzed patients, thus indicating that benralizumab is an attractive choice for patients due to eosinophilic count reduction as well as the less frequent dosing schedule. However, further studies are required, on larger populations.

Low Expression of ICAM-1 in Blood Eosinophils in Patients With Active Eosinophilic Esophagitis.

Eosinophilic esophagitis (EoE) is a chronic and isolated inflammation of the esophagus characterized by a marked infiltration of eosinophilic leukocytes. Diagnosis and course of the disease are based exclusively on histopathology. Therefore, patients must undergo several esophageal biopsies, implying a risk associated with the procedure and considerable use of resources. Objective: The presence of active circulating eosinophils, which are quantifiable through the expression of specific cellular activation proteins in their membrane, could be consistent with histopathological findings, which are currently the only valid parameters in studies on EoE. The activity of peripheral blood eosinophils from patients with EoE was analyzed by identifying 5 surface molecules (CD69, IL- 5Rα, CD44, ICAM-1, CD63), which are seen to be expressed by the active eosinophils in flow cytometry. The results were compared with the infiltrate of eosinophils present in patients' esophageal biopsies. ICAM-1 levels decreased significantly in patients with active EoE compared with nonactive EoE patients, allergic patients, and healthy controls. In patients with EoE, an inverse correlation was observed between the number of eosinophils in the esophageal biopsy and the percentage of ICAM-1 expression in peripheral blood eosinophils. No differences were observed for the remaining molecules studied. Expression of ICAM-1 in blood eosinophils could be a useful noninvasive marker for the diagnosis and assessment of patients with EoE.

The Significance of Blood Eosinophilia in Atopic Dermatitis

Background: Atopic dermatitis (AD) is chronic relapsing, pruritic, inflammatory skin disease. Itusually accompanies other atopic problems like asthma and allergic rhinitis. Eosinophil plays a rolein patients with AD.Objectives: To assess blood eosinophils in patients with AD and to evaluate the factors that areaffecting the blood eosinophilia.Materials and methods: This prospective study was conducted at Hit General Hospital in theperiod from October 2018-October 2019. The age, gender, and personal or family history of asthmaor allergic rhinitis of the patients with AD were recorded. The severity of the disease was assessedby the SCORAD score. The total number of eosinophil was measured for each subject. The datawere analyzed using SPSS version 22.Results: Out of 70 patients with AD, 38 (54.3%) were females, and 32 (45.7%) males. The age ofthe patients ranged from 8 months to 30 years (mean 7.59±7.40). The highest age group affectedwas 2-12 years 40 (57.1%). The SCORAD score ranged from 6-80 (mean 24.19±17.59). Themajority of our patients with mild course 50 (71.1%). The majority of the cases were without ahistory of asthma (n=53,75.7%), and around 50% without allergic rhinitis. The range of eosinophilcount was 42-3360 (mean 636.44±491.37). The majority of the subjects (n=53,75.7%) with mildeosinophilia (500-1500/ mm3). The age, gender, and patients with a history of allergic rhinitis orasthma had no significant effect on the number of eosinophils (P-Value >0.05). While, there wasa high statistically significant difference between the eosinophils count, and the severity of AD(P-Value=0.000).Conclusion: From these findings we concluded that blood eosinophilia is a relatively commonlaboratory finding of AD. Blood eosinophilia was influenced by the severity of AD.

Correlation between FEV1% Predicted and Blood Eosinophils in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)

Introduction: Chronic obstructive pulmonary disease (COPD) exacerbations are still the leading causes of mortality. Eosinophil counts were recommended in assessing the risk of exacerbations. This additional examination was preferred rather than the pulmonary function test (PFT), which was considered less precise and had vast differences. Therefore, an analysis of the correlation between the FEV1% predicted and blood eosinophil counts were needed as a reference in the diagnosis of COPD exacerbation. This study aimed to determine the correlation between FEV1% predicted and blood eosinophils counts in patients with COPD exacerbations.Methods: This was a retrospective cross-sectional study by analyzing medical records of patients with COPD exacerbations at Dr. Soetomo General Hospital, Surabaya, from 2017 to 2018.Results: The characteristics of patients with exacerbations of COPD consisted of 91.7% male patients. Most of them were in the age group of 61-70 years old, 58.3% were in the private sector, 75% had a high school diploma, and 41.7% had normal body mass index (BMI). The percentage of the FEV1% predicted is directly proportional to the percentage of blood eosinophils with weak and statistically insignificant strength.Conclusion: The FEV1% predicted and blood eosinophil counts had a very weak correlation and statistically insignificant strength. Thus, it could not be used as a reference for diagnosis using one of the variables. Further research is needed with sputum eosinophils and biopsy as consideration for more accurate results.

Prognostic Role of Blood Eosinophil Count in Patients with Sorafenib-Treated Hepatocellular Carcinoma.

Inflammation is a long-established hallmark of liver fibrosis and carcinogenesis. Eosinophils are emerging as crucial components of the inflammatory process influencing cancer development. The role of blood eosinophils in patients with hepatocellular carcinoma receiving systemic treatment is an unexplored field. The objective of this study was to analyse the prognostic role of the baseline eosinophil count in patients with sorafenib-treated hepatocellular carcinoma. A training cohort of 92 patients with advanced- or intermediate-stage sorafenib-treated hepatocellular carcinoma and two validation cohorts of 65 and 180 patients were analysed. Overall survival and progression-free survival in relation to baseline eosinophil counts were estimated by the Kaplan-Meier method. Univariate and multivariate analyses were performed. A negative prognostic impact of low baseline eosinophil counts (< 50*109/L) was demonstrated in all cohorts (training cohort: hazard ratio = 50.1, 95% confidence interval 11.6-216.5, p < 0.0001 for low vs high eosinophil counts; first validation cohort: hazard ratio = 4.55, 95% confidence interval 1.24-16.65, p = 0.022; second validation cohort: hazard ratio = 3.21, 95% confidence interval 1.83-5.64, p < 0.0001). Moreover, low eosinophil counts had a negative prognostic role in patients progressing on or intolerant to sorafenib who received second-line regorafenib, but not capecitabine or best supportive care. Our analysis identified baseline blood eosinophil counts as a new prognostic factor in patients with sorafenib-treated hepatocellular carcinoma. Concerning second-line therapies, eosinophil counts were associated with survival outcomes only in regorafenib-treated patients, suggesting a possible predictive role in this setting.

Blood Eosinophil Count and Hospital Readmission in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

PurposeThis retrospective, observational cohort study investigated the association of blood eosinophil counts within 1 week of hospitalization for acute exacerbation of COPD (AECOPD) with subsequent risk of all-cause and COPD-related readmission from a large integrated health system.Patients and MethodsElectronic medical records were extracted for index hospitalization for AECOPD at all Intermountain Healthcare hospitals. The primary outcome was the relationship of blood eosinophil count to 30-day all-cause readmission; secondary outcomes were 60-day, 90-day, and 12-month all-cause readmission, COPD-related readmission, and empiric derivation of the eosinophil count with the highest area under the curve (AUC) for predicting 30-day all-cause readmission.ResultsOf 2445 included patients, 1935 (79%) had a blood eosinophil count <300 cells/µL and 510 (21%) had a count ≥300 cells/µL. Using a 300-cells/μL threshold, there was no significant difference between high and low eosinophil groups in 30-day (odds ratio [OR]=1.05, 95% confidence interval [CI]=0.75–1.47) or 60-day (OR=1.15, 95% CI=0.88–1.51) all-cause readmissions. However, patients with greater (versus lesser) eosinophil counts had increased 90-day and 12-month all-cause readmissions (OR=1.35, 95% CI=1.06–1.72, and OR=1.32, 95% CI=1.07–1.62). COPD-related readmission rates were significantly greater for patients with greater (versus lesser) eosinophil counts at 30, 60, and 90 days and 12 months (OR range=1.52–1.97). A total of 70 cells/µL had the most discriminatory power to predict 30-day all-cause readmission (highest AUC).ConclusionEosinophil counts in patients with COPD were not associated with a difference in 30-day all-cause readmissions. However, greater eosinophil counts were associated with increased risk of all-cause readmission at 90 days and 12 months and COPD-related readmission at 30, 60, and 90 days and 12 months. Patients with eosinophils <70 cells/μL had the lowest risk for 30-day all-cause readmission. Blood eosinophils in patients hospitalized with AECOPD may be a useful biomarker for the risk of hospital readmission.