COPD exacerbation severity and frequency is associated with impaired macrophage efferocytosis of eosinophils

BMC Pulmonary Medicine

Christopher Brightling²  Neeta Kulkarni³  Beverley Hargadon²  Adam Wright³  Fay Hollins³  Mona Bafadhel⁴  Osama Eltboli¹ 

[1] Department of Medicine, Faculty of Medicine, Benghazi University, Benghazi, Libya;Department of Respiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, UK;Institute for Lung Health, NIHR Respiratory Biomedical Research Unit, Department of Infection, Immunity & Inflammation, University of Leicester, Leicester, UK;Department of Respiratory Medicine, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK

关键词: Exacerbation;    Efferocytosis;    Eosinophils;    COPD;   

Others  :  1109587
DOI  :  10.1186/1471-2466-14-112

 received in 2014-03-13, accepted in 2014-07-01,  发布年份 2014

【 摘 要 】

Background

Eosinophilic airway inflammation is observed in 10-30% of COPD subjects. Whether increased eosinophils or impairment in their clearance by macrophages is associated with the severity and frequency of exacerbations is unknown.

Methods

We categorised 103 COPD subjects into 4 groups determined by the upper limit of normal for their cytoplasmic macrophage red hue (<6%), an indirect measure of macrophage efferocytosis of eosinophils, and area under the curve sputum eosinophil count (≥3%/year). Eosinophil efferocytosis by monocyte-derived macrophages was studied in 17 COPD subjects and 8 normal controls.

Results

There were no differences in baseline lung function, health status or exacerbation frequency between the groups: A-low red hue, high sputum eosinophils (n = 10), B-high red hue, high sputum eosinophils (n = 16), C-low red hue, low sputum eosinophils (n = 19) and D- high red hue, low sputum eosinophils (n = 58). Positive bacterial culture was lower in groups A (10%) and B (6%) compared to C (44%) and D (21%) (p = 0.01). The fall in FEV₁ from stable to exacerbation was greatest in group A (ΔFEV₁ [95 % CI] -0.41 L [-0.65 to -0.17]) versus group B (-0.16 L [-0.32 to -0.011]), C (-0.11 L [-0.23 to -0.002]) and D (-0.16 L [-0.22 to -0.10]; p = 0.02). Macrophage efferocytosis of eosinophils was impaired in COPD versus controls (86 [75 to 92]% versus 93 [88 to 96]%; p = 0.028); was most marked in group A (71 [70 to 84]%; p = 0.0295) and was inversely correlated with exacerbation frequency (r = -0.63; p = 0.006).

Conclusions

Macrophage efferocytosis of eosinophils is impaired in COPD and is related to the severity and frequency of COPD exacerbations.

【 授权许可】

   
2014 Eltboli et al.; licensee BioMed Central Ltd.

【 图 表 】

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