Eosinophils, mucus plugs and clinical outcomes: findings from two COPD cohorts
Alejandro A. Díaz, Scott Grumley, Andrew Yen, Sushilkumar K. Sonavane, Rim Elalami, Maya Abdalla, Kangjin Kim, Pietro Nardelli, Sharon S. Brouha, Padma P. Manapragada, Mostafa Abozeed, Muhammad Usman Aziz, Mohd Zahid, Hrudaya Nath, Wei Wang, James C. Ross, Carrie L. Pistenmaa, Raúl San Jośe Estépar, Michael H. Cho
Abstract
<title>Extract</title> Type 2 inflammation (Th2i) —indicated by blood eosinophil counts— and airway-occluding mucus plugs (MPs) on computed tomography (CT) are frequent phenotypes in people with COPD. [1–4] Furthermore, the Th2i pathway involves type 2 helper T cells and epithelial-derived cytokines, such as interleukin (IL-) 33 and thymic stromal lymphopoietin (TSLP), that drive a cascade of events, including eosinophils mobilization and activation in the airways. [5] A persistent Th2i milieu leads to airway structural changes, such as mucus gland hypertrophy, ensuing mucus hypersecretion, and plug formation. [5, 6] Therefore, we tested the hypothesis that high blood eosinophils are associated with airway MPs. We also sought to determine the association of those phenotypes with functional and clinical measures of COPD.