Beyond eosinophilia: inflammatory patterns in patients with asthma.

Background: Recently, inflammatory cell ratios have gained importance as useful indicators in the categorization of asthma.Objective: We compared the concentration of white blood cells in peripheral blood, as well as their respective inflammatory cell ratios, between patients with asthma and a healthy control group.Methods: We performed cross-sectional analyses of the data obtained from 53 adult patients with asthma and 109 adult controls. In our study, we estimated and compared the following inflammatory cell ratios: Neutrophil-Lymphocyte Ratio (NLR), Eosinophil-Lymphocyte Ratio (ELR), Eosinophil-Neutrophil Ratio (ENR), Eosinophil-Monocyte Ratio (EMR), and Platelet-Lymphocyte Ratio (PLR). The magnitude of association was quantified with the odds ratio.Results: In both groups, the average age was 33 years. In asthmatic patients, we obtained the following results: eosinophils ≥ 400 cells/µl, accounted for 37.7%; basophils ≥ 110 cells/µl, comprised 37.7%; and monocytes < 320 cells/µl, reached 11.3%. In the control group, the results were as follows: 4.6%, 9.2% and 0.9%, respectively. When compared to the control group, asthmatic patients had higher odds of eosinophils ≥ 400 cells/µl (OR = 12.61, p < 0.0001); higher odds of basophils ≥ 110 cells/µl (OR = 6.00, p < 0.0001); and increased odds of monocytes < 320 cells/µl (OR = 13.79, p = 0.017). NLR did not differ between our two groups; however, ELR, ENR, EMR and PLR were significantly higher in the asthma group.Conclusions: Overall, patients with asthma have a higher concentration of eosinophils and basophils, fewer monocytes in their blood, and higher ratios of increased chronic inflammation.

[Prevalence of blood eosinophilia in adults with COPD according to the cut-off point]. / Prevalencia de eosinofilia en sangre en adultos con EPOC según el punto de corte.

OBJECTIVE: To determine the prevalence of blood eosinophilia in adults with chronic obstructive pulmonary disease (COPD) according to different cut-off points. METHODS: A cross-sectional study was carried out in patients with COPD. The frequency of blood eosinophilia was determined by absolute (cells/ µL) and relative (%) eosinophil count. Multivariate methods were used in order to identify the associated factors. RESULTS: 81 patients were included; the mean age was 71.9 ± 9.8 years; 46 (57%) of the patients were men. The prevalence of eosinophilia for the cut-off points of ≥ 100, ≥ 150, ≥ 200, ≥ 300, and ≥ 400 cells/µL was of 64.2%, 37.0%, 16.1%, and 9.9% respectively. Out of 81 patients, 34 (42%) had a relative eosinophil concentration of ≥ 2%; 21 (25.9%) ≥ 3%; 14 patients (17.3%) had ≥ 4%; and 10 patients (12.3%) had ≥ 5%. Eosinophilia of ≥ 100 cells/µL was associated with age of ≥ 80 years (OR = 6.04, p = 0.026), and with the exacerbation of COPD (OR = 9.40, p = 0.038); in contrast, eosinophilia of ≥ 2% was associated only with age of ≥ 80 years (OR = 3.73, p = 0.020). In addition, the eosinophil count of ≥ 100 and < 300 cells/µL was associated with the exacerbation of COPD (OR = 11.00, p = 0.026). CONCLUSIONS: Our results suggest that the frequency of eosinophilia in the context of COPD shows substantial variations according to the used definition.

Objetivo: Establecer la prevalencia de eosinofilia en sangre en adultos con enfermedad pulmonar obstructiva crónica (EPOC) según varios puntos de corte. Métodos: Se realizó un estudio transversal en pacientes con EPOC. La frecuencia de eosinofilia en sangre se determinó a partir de la concentración absoluta (células/µL) y relativa (%) de eosinófilos. Fueron realizados modelos multivariados para identificar factores asociados. Resultados: En 81 pacientes incluidos, la edad promedio fue de 71.9 ± 9.8 años; de los cuales, 46 (57 %) fueron hombres. La prevalencia de eosinofilia para los puntos de corte ≥ 100, ≥ 150, ≥ 200, ≥ 300 y ≥ 400 células/µL fue de 64.2, 43.2, 37.0, 16.1 y 9.9 %, respectivamente. De 81 pacientes, 34 (42 %) tuvieron una concentración ≥ 2 %; 21 (25.9 %) ≥ 3 %; 14 (17.3 %) ≥ 4 %; y 10 (12.3 %) ≥ 5 %. La eosinofilia ≥ 100 células/µL se asoció con la edad ≥ 80 años (RM = 6.04, p = 0.026) y con la exacerbación de la EPOC (RM = 9.40, p = 0.038); en cambio, la eosinofilia ≥ 2 %, lo hizo con solamente la edad ≥ 80 años (RM = 3.73, p = 0.020). Complementariamente, la concentración de eosinófilos ≥ 100 y < 300 células/µL se asoció con la exacerbación de la EPOC (RM = 11.00, p = 0.026). Conclusiones: Nuestros resultados sugieren que la frecuencia de eosinofilia en EPOC muestra variaciones sustanciales según la definición adoptada.

[Obesity in adulthood is associated with the severity of asthma, but not with asthma control]. / La obesidad en adultos está asociada con la gravedad del asma, pero no con el control del asma.

BACKGROUND: The impact of obesity on the severity of asthma continues to be a cause of controversy. OBJECTIVE: To compare the severity of asthma and asthma control in obese patients with non-obese patients. METHODS: A cross-sectional study which included 188 patients with asthma, of ≥ 18 years of age, who were selected consecutively. The patients were categorized and compared based on the presence or absence of obesity. In order to establish an association between variables, logistic regression analyses were performed. RESULTS: In total, 111/188 of the patients had obesity; these patients were older than those without obesity (35.9 ± 15.3 years vs. 44.4 ± 13.8 years, p <0.001). No significant difference was observed in the groups regarding sex, total IgE serum concentration, peripheral blood eosinophil count, personal history of atopic diseases, frequency of allergic sensitization, hospitalization for asthma, and asthma control. Overall, obesity was significantly associated with moderate-severe asthma (OR = 1.82, p = 0.047), but not with asthma control (p = 0.094). CONCLUSIONS: Our results suggest that patients with asthma and obesity are older and that their pulmonary function is worse, which is reflected in a greater level of severity of asthma.

Antecedentes: El impacto de la obesidad sobre la gravedad del asma contiúa siendo motivo de controversia. Objetivo: Comparar la gravedad y el control del asma entre pacientes con obesidad y sin obesidad. Métodos: Estudio transversal que incluyó a 188 pacientes con asma, con edad ≥ 18 años, seleccionados consecutivamente. Los pacientes fueron categorizados y comparados de acuerdo con la presencia de obesidad o no. Para establecer asociación entre variables se realizó análisis de regresión logística. Resultados: En total, 111 pacientes tenían obesidad; su edad fue mayor que la de los pacientes sin obesidad (35.9 ± 15.3 años versus 44.4 ± 13.8 años, p < 0.001). No se observó diferencia significativa entre los grupos respecto a sexo, concentración sérica total de IgE, número de eosinófilos en sangre periférica, historia personal de enfermedad atópica, frecuencia de sensibilización alérgica, hospitalización por asma y control del asma. En general, la obesidad se asoció significativamente con el asma moderada o grave (RM = 1.82, p = 0.047), pero no lo hizo con el control del asma (p = 0.094). Conclusiones: Nuestros resultados sugieren que los pacientes con asma y obesidad tienen mayor edad y peor función pulmonar, la cual se reflejada en mayor gravedad del asma.