Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease

Treating patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (COPD) usually involves administering systemic corticosteroids. The many unwanted side effects associated with this treatment have led to increased interest in minimising the accumulated corticosteroid d...

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Main Authors: Pradeesh Sivapalan, András Bikov, Jens-Ulrik Jensen
Format: Article
Language:English
Published: MDPI AG 2021-02-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/11/2/236
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spelling doaj-8fadf43300254e10a61f18341924c4e92021-02-04T00:06:25ZengMDPI AGDiagnostics2075-44182021-02-011123623610.3390/diagnostics11020236Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary DiseasePradeesh Sivapalan0András Bikov1Jens-Ulrik Jensen2Respiratory Medicine Section, Department of Internal Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkWythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UKRespiratory Medicine Section, Department of Internal Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkTreating patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (COPD) usually involves administering systemic corticosteroids. The many unwanted side effects associated with this treatment have led to increased interest in minimising the accumulated corticosteroid dose necessary to treat exacerbations. Studies have shown that short-term treatment with corticosteroids is preferred, and recent trials have shown that biomarkers can be used to further reduce exposure to corticosteroids. Interestingly, high eosinophil counts in patients with acute exacerbations of COPD are indicative of an eosinophilic phenotype with a distinct response to treatment with corticosteroids. In addition, post-hoc analysis of randomised control trials have shown that higher blood eosinophil counts at the start of the study predict a greater response to inhaled corticosteroids in stable COPD. In this review, we examine the studies on this topic, describe how blood eosinophil cell count may be used as a biomarker to guide treatment with corticosteroids, and identify some relevant challenges.https://www.mdpi.com/2075-4418/11/2/236chronic obstructive pulmonary diseaseblood eosinophil countsystemic corticosteroidsbiomarkersinhaled corticosteroids
collection DOAJ
language English
format Article
sources DOAJ
author Pradeesh Sivapalan
András Bikov
Jens-Ulrik Jensen
spellingShingle Pradeesh Sivapalan
András Bikov
Jens-Ulrik Jensen
Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease
Diagnostics
chronic obstructive pulmonary disease
blood eosinophil count
systemic corticosteroids
biomarkers
inhaled corticosteroids
author_facet Pradeesh Sivapalan
András Bikov
Jens-Ulrik Jensen
author_sort Pradeesh Sivapalan
title Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease
title_short Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease
title_full Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease
title_fullStr Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease
title_full_unstemmed Using Blood Eosinophil Count as a Biomarker to Guide Corticosteroid Treatment for Chronic Obstructive Pulmonary Disease
title_sort using blood eosinophil count as a biomarker to guide corticosteroid treatment for chronic obstructive pulmonary disease
publisher MDPI AG
series Diagnostics
issn 2075-4418
publishDate 2021-02-01
description Treating patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (COPD) usually involves administering systemic corticosteroids. The many unwanted side effects associated with this treatment have led to increased interest in minimising the accumulated corticosteroid dose necessary to treat exacerbations. Studies have shown that short-term treatment with corticosteroids is preferred, and recent trials have shown that biomarkers can be used to further reduce exposure to corticosteroids. Interestingly, high eosinophil counts in patients with acute exacerbations of COPD are indicative of an eosinophilic phenotype with a distinct response to treatment with corticosteroids. In addition, post-hoc analysis of randomised control trials have shown that higher blood eosinophil counts at the start of the study predict a greater response to inhaled corticosteroids in stable COPD. In this review, we examine the studies on this topic, describe how blood eosinophil cell count may be used as a biomarker to guide treatment with corticosteroids, and identify some relevant challenges.
topic chronic obstructive pulmonary disease
blood eosinophil count
systemic corticosteroids
biomarkers
inhaled corticosteroids
url https://www.mdpi.com/2075-4418/11/2/236
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