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- Title
Blood neutrophil counts are associated with exacerbation frequency and mortality in COPD.
- Authors
Lonergan, Mike; Dicker, Alison J.; Crichton, Megan L.; Keir, Holly R.; Van Dyke, Melissa K.; Mullerova, Hana; Miller, Bruce E.; Tal-Singer, Ruth; Chalmers, James D.
- Abstract
<bold>Background: </bold>Identifying patients with COPD at increased risk of poor outcomes is challenging due to disease heterogeneity. Potential biomarkers need to be readily available in real-life clinical practice. Blood eosinophil counts are widely studied but few studies have examined the prognostic value of blood neutrophil counts (BNC).<bold>Methods: </bold>In a large population-based COPD registry in the East of Scotland (TARDIS: Tayside Allergic and Respiratory Disease Information System), BNC were compared to measures of disease severity and mortality for up to 15 years follow-up. Potential mechanisms of disease modification by BNC were explored in a nested microbiome substudy.<bold>Results: </bold>178,120 neutrophil counts were obtained from 7220 people (mean follow up 9 years) during stable disease periods. Median BNC was 5200cells/μL (IQR 4000-7000cells/μL). Mortality rates among the 34% of patients with elevated BNCs (defined as 6000-15000cells/μL) at the study start were 80% higher (14.0/100 person years v 7.8/100py, P < 0.001) than those with BNC in the normal range (2000-6000cells/μL). People with elevated BNC were more likely to be classified as GOLD D (46% v 33% P < 0.001), have more exacerbations (mean 2.3 v 1.3/year, P < 0.001), and were more likely to have severe exacerbations (13% vs. 5%, P < 0.001) in the following year. Eosinophil counts were much less predictive of these outcomes. In a sub-cohort (N = 276), patients with elevated BNC had increased relative abundance of Proteobacteria and reduced microbiome diversity.<bold>Conclusion: </bold>High BNC may provide a useful indicator of risk of exacerbations and mortality in COPD patients.
- Subjects
SCOTLAND; OBSTRUCTIVE lung diseases; RESPIRATORY diseases; MORTALITY; BLOOD; ALLERGIES
- Publication
Respiratory Research, 2020, Vol 21, Issue 1, p1
- ISSN
1465-9921
- Publication type
journal article
- DOI
10.1186/s12931-020-01436-7