Simultaneous evaluation of the fractional exhaled nitric oxide and blood eosinophil count of T2-high endotype in patients with non-cystic fibrosis bronchiectasis.

IF 3.5 3区医学 Q2 RESPIRATORY SYSTEM

Chronic Respiratory Disease Pub Date : 2023-01-01 DOI:10.1177/14799731231210559

Fengjia Chen, Zhimin Zeng, Xinyan Huang, Yangli Liu

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Abstract

Objective: Recently, a type 2 inflammation (T2) high endotype in bronchiectasis was identified. The fraction of exhaled nitric oxide (FeNO) and blood eosinophil count (BEC) are recognized as representative biomarkers of T2 inflammation. Herein, we investigate the clinical characteristics of T2-high endotype in non-cystic fibrosis bronchiectasis patients classified by FeNO and BEC.

Methods: This retrospective study included 164 bronchiectasis patients treated in the First Affiliated Hospital of Sun Yat-sen University from December 2017 to July 2022. Clinical characteristics were analyzed after classifying patients into four groups according to T2 inflammation biomarkers (FeNO ≥25 ppb; BEC ≥200/µL).

Results: Among the 164 bronchiectasis patients, 35.3% (58/164) presented with high FeNO, 30.5% (50/164) presented with high BEC, and 10.4% (17/164) had high FeNO and BEC. Patients with high FeNO and low BEC presented with better lung function, fewer affected lobes, and lower dyspnea prevalence compared with the three other groups. Moreover, decreased FeNO, instead of decreased BEC, is revealed to be an independent predictor for disease severity and airflow obstruction in bronchiectasis.

Conclusions: Simultaneous evaluation of FeNO and BEC proposed different endotypes of bronchiectasis established that patients with low BEC and high FeNO had better lung function, fewer affected lobes, lower dyspnea prevalence, and less disease severity. This result will contribute to a more comprehensive assessment of the disease severity and lead to more precise treatment of T2 inflammation in bronchiectasis patients.

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同时评估非囊性纤维化支气管扩张患者T2高内型呼出一氧化氮分数和血液嗜酸性粒细胞计数。

目的：近年来发现支气管扩张症的2型炎症（T2）高内型。呼出一氧化氮（FeNO）的分数和血液嗜酸性粒细胞计数（BEC）被认为是T2炎症的代表性生物标志物。在此，我们研究了按FeNO和BEC分类的非囊性纤维化支气管扩张患者T2高内型的临床特征。方法：本回顾性研究纳入2017年12月至2022年7月在中山大学附属第一医院接受治疗的164例支气管扩张症患者。根据T2炎症生物标志物（FeNO≥25 ppb；BEC≥200/µL）将患者分为四组后，分析临床特征。结果：164例支气管扩张症患者中，35.3%（58/164）表现为高FeNO，30.5%（50/164）表现高BEC，10.4%（17/164）表现出高FeNO和BEC。与其他三组相比，高FeNO和低BEC患者的肺功能更好，受影响的肺叶更少，呼吸困难发生率更低。此外，FeNO的减少，而不是BEC的减少，被发现是支气管扩张症疾病严重程度和气流阻塞的独立预测因素。结论：FeNO和BEC的同时评估提出了不同的支气管扩张内型，这表明低BEC和高FeNO患者具有更好的肺功能、更少的受累肺叶、更低的呼吸困难发生率和更低的疾病严重程度。这一结果将有助于更全面地评估疾病的严重程度，并对支气管扩张症患者的T2炎症进行更精确的治疗。

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来源期刊

Chronic Respiratory Disease RESPIRATORY SYSTEM-

CiteScore

5.90

自引率

7.30%

发文量

审稿时长

11 weeks

期刊介绍： Chronic Respiratory Disease is a peer-reviewed, open access, scholarly journal, created in response to the rising incidence of chronic respiratory diseases worldwide. It publishes high quality research papers and original articles that have immediate relevance to clinical practice and its multi-disciplinary perspective reflects the nature of modern treatment. The journal provides a high quality, multi-disciplinary focus for the publication of original papers, reviews and commentary in the broad area of chronic respiratory disease, particularly its treatment and management.