Phenotypic Clustering in Non-Cystic Fibrosis Bronchiectasis Patients: The Role of Eosinophils in Disease Severity
Por:
Wang, XJ, Villa, C, Dobarganes, Y, Olveira, C, Giron, R, Garcia-Clemente, M, Maiz, L, Sibila, O, Golpe, R, Menendez, R, Rodriguez-Lopez, J, Prados, C, Martinez-Garcia, MA, Rodriguez, JL, de la Rosa, D, Duran, X, Garcia-Ojalvo, J, Barreiro, E
Publicada:
1 ago 2021
Resumen:
Whether high blood eosinophil counts may define a better phenotype in bronchiectasis patients, as shown in chronic obstructive pulmonary disease (COPD), remains to be investigated. Differential phenotypic characteristics according to eosinophil counts were assessed using a biostatistical approach in a large cohort study from the Spanish Online Bronchiectasis Registry (RIBRON). The 906 patients who met the inclusion criteria were clustered into two groups on the basis of their eosinophil levels. The potential differences according to the bronchiectasis severity index (BSI) score between two groups (Mann-Whitney U test and eosinophil count threshold: 100 cells/mu L) showed the most balanced cluster sizes: above-threshold and below-threshold groups. Patients above the threshold exhibited significantly better clinical outcomes, lung function, and nutritional status, while showing lower systemic inflammation levels. The proportion of patients with mild disease was higher in the above-threshold group, while the below-threshold patients were more severe. Two distinct clinical phenotypes of stable patients with non-cystic fibrosis (CF) bronchiectasis of a wide range of disease severity were established on the basis of blood eosinophil counts using a biostatistical approach. Patients classified within the above-threshold cluster were those exhibiting a mild disease, significantly better clinical outcomes, lung function, and nutritional status while showing lower systemic inflammatory levels. These results will contribute to better characterizing bronchiectasis patients into phenotypic profiles with their clinical implications.
Filiaciones:
Wang, XJ:
Hosp del Mar IMIM, Pulmonol Dept, Lung Canc & Muscle Res Grp, Parc Salut Mar, Barcelona 08003, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona 08193, Spain
Villa, C:
Clin Fuensanta, Resp Dept, Madrid 28027, Spain
Dobarganes, Y:
Clin Fuensanta, Resp Dept, Madrid 28027, Spain
Olveira, C:
Univ Malaga, Hosp Reg Univ Malaga, Inst Invest Biomed Malaga IBIMA, Resp Dept, Malaga 29010, Spain
Giron, R:
Hosp Univ la Princesa, Inst Invest Sanitaria, Resp Dept, Madrid 28006, Spain
Garcia-Clemente, M:
Hosp Univ Cent Asturias, Resp Dept, Oviedo 33011, Spain
Maiz, L:
Hosp Ramon & Cajal, Resp Dept, Madrid 28034, Spain
Sibila, O:
Hosp Clin Barcelona, Resp Dept, Barcelona 08036, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Red Enfermedades Resp CIBERES, Madrid 28029, Spain
Golpe, R:
Hosp Lucus Augusti, Resp Dept, Lugo 27003, Spain
Menendez, R:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia 46026, Spain
Rodriguez-Lopez, J:
Hosp San Agustin, Resp Dept, Aviles 33401, Asturias, Spain
Prados, C:
Hosp la Paz, Resp Dept, Madrid 28046, Spain
Martinez-Garcia, MA:
Inst Salud Carlos III ISCIII, Ctr Invest Red Enfermedades Resp CIBERES, Madrid 28029, Spain
Hosp Univ & Politecn La Fe, Resp Dept, Valencia 46026, Spain
Rodriguez, JL:
Hosp Clin San Carlos, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Resp Dept, Madrid 28040, Spain
Univ Complutense Madrid, Dept Med, Madrid 28040, Spain
de la Rosa, D:
Hosp Santa Creu & Sant Pau, Resp Dept, Barcelona 08041, Spain
Duran, X:
Hosp del Mar IMIM, Sci & Tech Dept, Barcelona 08003, Spain
Garcia-Ojalvo, J:
Univ Pompeu Fabra UPF, Dept Hlth & Expt Sci CEXS, Barcelona 08002, Spain
Barreiro, E:
Hosp del Mar IMIM, Pulmonol Dept, Lung Canc & Muscle Res Grp, Parc Salut Mar, Barcelona 08003, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Red Enfermedades Resp CIBERES, Madrid 28029, Spain
Univ Pompeu Fabra UPF, Dept Hlth & Expt Sci CEXS, Barcelona 08002, Spain
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