Specific airway inflammatory cell types reflected different airway inflammatory phenotypes. Chronic airway inflammation in COPD exacerbations with increased numbers of inflammatory cell, such as neutrophils, eosinophils, macrophages, and lymphocytes, are response to different parts of the lung and lead to structural changes. Acute exacerbations of COPD (AECOPD) are defined as an acute worsening of respiratory symptoms that result in additional therapy and important events in the management of COPD because they negatively impact health status, rates of hospitalization and readmission, and disease progression. Due to weak relationship and poor predictive ability, more researches should be required.Ĭhronic obstructive pulmonary disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. Eosinophils in blood and the ratios (ENR, EMR and ELR) may be utilized to assess eosinophilic airway inflammation in COPD exacerbations. ConclusionĮosinophils/neutrophils count parameters were relationship between blood and sputum. ELR, eosinophil/monocyte ratio (EMR) and eosinophil/neutrophil ratio (ENR) in blood were higher in COPD exacerbations with mixed granulocytic and eosinophilic subtypes. Blood eosinophils absolute count was also predictive sputum eosinophilia at 0.35 × 10 9/L (AUC = 0.626, p = 0.025). The optimum cutpoint for blood eosinophils percentage was 0.55%. Blood eosinophils percentage was predictive for eosinophilic COPD exacerbations with an area under the curve (AUC) of 0.672 ( p = 0.012). Sputum neutrophils had not any association with neutrophil/macrophage ratio (NMR) and eosinophil/lymphocyte ratio (ELR) in blood. There was a weaker relationship to neutrophils between sputum and blood. There was a correlation between sputum eosinophils and blood eosinophils, blood cells derived ratios. This 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. 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. The venous blood cell is a reliable and simple biomarker, may be used as an alternative procedure to reflect the subtypes. Measurement of sputum is frequently used to define airway inflammatory subtypes.
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