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FEV1 decline in relation to blood eosinophils and neutrophils in a population-based asthma cohort
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Dept of Health Sciences, Luleå University of Technology, Luleå, Sweden.. (the OLIN Unit, Umeå University, Umeå, Sweden.)ORCID iD: 0000-0002-0553-8067
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.ORCID iD: 0000-0002-3292-7471
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. Dept of Health Sciences, Luleå University of Technology, Luleå, Sweden.. (the OLIN Unit, Umeå University, Umeå, Sweden.)ORCID iD: 0000-0002-1630-3167
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Dept of Health Sciences, Luleå University of Technology, Luleå, Sweden..
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2020 (English)In: The World Allergy Organization journal, ISSN 1939-4551, Vol. 13, no 3, article id 100110Article in journal (Refereed) Published
Abstract [en]

Background: The relationship between lung function decline and eosinophils and neutrophils has important therapeutic implications among asthmatics, but it has rarely been studied in large cohort studies.

Objective: The aim is to study the relationship between blood eosinophils and neutrophils and FEV1 decline in a long-term follow-up of a population-based adult asthma cohort.

Methods: In 2012-2014, an adult asthma cohort was invited to a follow-up including spirometry, blood sampling, and structured interviews, and n = 892 participated (55% women, mean age 59 y, 32-92 y). Blood eosinophils, neutrophils and FEV 1 decline were analyzed both as continuous variables and divided into categories with different cut-offs. Regression models adjusted for smoking, exposure to vapors, gas, dust, or fumes (VGDF), use of inhaled and oral corticosteroids, and other possible confounders were utilized to analyze the relationship between eosinophils and neutrophils at follow-up and FEV1 decline.

Results: The mean follow-up time was 18 years, and the mean FEV 1 decline was 27 ml/year. The annual FEV1 decline was related to higher levels of both blood eosinophils and neutrophils at follow-up, but only the association with eosinophils remained when adjusted for confounders. Further, the association between FEV1 decline and eosinophils was stronger among those using ICS. With EOS <0.3 × 109/L as reference, a more rapid decline in FEV1 was independently related to EOS ≥0.4 × 109/L in adjusted analyses.

Conclusions and clinical relevance: Besides emphasizing the importance of smoking cessation and reduction of other harmful exposures, our real-world results indicate that there is an independent relationship between blood eosinophils and FEV1 decline among adults with asthma.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 13, no 3, article id 100110
Keywords [en]
ANOVA, Analysis of variance, ATS, American Thoracic Society, Asthma, BMI, Body mass index, Cohort, ECRHS, European Community Respiratory Health Survey, EOS, Eosinophils, ERS, European Respiratory Society, Eosinophils, FEV1, FEV1, Forced Expiratory Volume in 1 s, FEV1pp, FEV1 percent of predicted, FVC, Forced Expiratory Volume, GLI, Global Lung function Initiative, ICS, Inhaled corticosteroids, IgE, Immunoglobulin E, L, Liters, Ml, Milliliters, N, Number, NEU, Neutrophils, Neutrophils, OCS, Oral corticosteroids, OLIN, Obstructive Lung Disease in Northern Sweden, OLS, Ordinary Least Squares, VGDF, Vapors, gas, dust or fumes
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-169223DOI: 10.1016/j.waojou.2020.100110PubMedID: 32206161OAI: oai:DiVA.org:umu-169223DiVA, id: diva2:1416972
Funder
Swedish Heart Lung FoundationSwedish Research CouncilVästerbotten County CouncilNorrbotten County CouncilSwedish Asthma and Allergy AssociationVisare NorrAvailable from: 2020-03-26 Created: 2020-03-26 Last updated: 2020-03-27Bibliographically approved

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Backman, HelenaLindberg, AnneHedman, LinneaStridsman, CarolineJansson, Sven-ArneSandström, ThomasRönmark, Eva

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