52ec7c121269903709528b6f5f09eef5 303898.pdf d1ec9b57558283efbde3a2dd7367d5b0ad5ca87c 303898.pdf 509ce703911d30ae29fe2d2258c502f02acb4c504f3cb9432e22bc6fd8cfab78 303898.pdf Title: Bronchiectasis-COPD Overlap Syndrome: Role of Peripheral Eosinophil Count and Inhaled Corticosteroid Treatment Subject: Both chronic obstructive pulmonary disease and bronchiectasis are highly prevalent diseases. In both cases, inhaled corticosteroids (ICs) are associated with a decrease in exacerbations in patients with a high peripheral blood eosinophil count (BEC), but it is still not known what occurs in bronchiectasis-COPD overlap syndrome (BCOS). The present study aimed to assess the effect of ICs on various outcomes in patients with BCOS, according to BEC values. We undertook a post-hoc analysis of a cohort of 201 GOLD II-IV COPD patients with a long-term follow-up (median 74 [IQR: 40–106] months). All participants underwent computerized tomography and 115 (57.2%) had confirmed BCOS. A standardized clinical protocol was followed and two sputum samples were collected at each medical visit (every 3–6 months), whenever possible. During follow-up, there were 68 deaths (59.1%), and the mean rate of exacerbations and hospitalizations per year was 1.42 (1.2) and 0.57 (0.83), respectively. A total of 44.3% of the patients presented at least one pneumonic episode per year. The mean value of eosinophils was 402 (112) eosinophils/L, with 27 (23.5%), 63 (54.8%), and 25 patients (21.7%) presenting, respectively, less than 100, 101–300, and more than 300 eosinophils/L. A total of 84 patients (73.1%) took ICs. The higher the BEC, the higher the annual rate of exacerbations and hospitalizations. Patients with less than 100 eosinophils/L presented more infectious events (incident exacerbations, pneumonic episodes, and chronic bronchial infection via pathogenic bacteria). Only those patients with eosinophilia (>300 eosinophils/L) treated with ICs decreased the number (1.77 (1.2) vs. 1.08 (0.6), p < 0.001) and the severity (0.67 (0.8) vs. 0.35 (0.5), p = 0.011) of exacerbations, without any changes in the other infectious outcomes or mortality. In conclusion, ICs treatment in patients with BCOS with increased BEC decreased the number and severity of incident exacerbations without any negative influence on other infectious outcomes (incidence of pneumonia or chronic bronchial infection). Keywords: overlap bronchiectasis-COPD; bronchiectasis; eosinophils; inhaled corticosteroids; mortality Author: Grace Oscullo, Jose Daniel Gómez-Olivas, Marina Ingles, Sergio Mompean, Rosalia Martinez-Perez, Guillermo Suarez-Cuartin, David la Rosa-Carrillo and Miguel Angel Martinez-Garcia Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Oct 13 11:49:23 2023 CEST ModDate: Fri Oct 13 11:51:14 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1337468 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- EIFDAO+VnURWPalladioL Type 1 Custom yes yes no 10 0 ZXDKIP+EURM10 Type 1 Builtin yes yes no 15 0 VXXJHE+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 RAZGZA+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 ZFODXL+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 SOZKOC+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 53 0 EILUJF+CMSY10 Type 1 Builtin yes yes no 78 0 XIRVNA+EURB10 Type 1 Builtin yes yes no 85 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 89 0 CFNAML+Symbol Type 1C Custom yes yes yes 99 0 CFNAMM+Arial CID TrueType Identity-H yes yes yes 104 0 CFMNLF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 110 0 CFMNLH+PalatinoLinotype TrueType WinAnsi yes yes no 113 0 CFMNMJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 116 0 CFMOLE+PalatinoLinotype TrueType MacRoman yes yes no 119 0 CFNAML+Symbol Type 1C Custom yes yes yes 127 0 CFNAMM+Arial CID TrueType Identity-H yes yes yes 132 0 CFMNLF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 138 0 CFMNLH+PalatinoLinotype TrueType WinAnsi yes yes no 141 0 CFMNMJ+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 144 0 CFMOLE+PalatinoLinotype TrueType MacRoman yes yes no 147 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-12-18 02:51:08 CET RepresentationInformation: 303898.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-12-17 08:30:38 CET Size: 1337468 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 347 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methods Destination: section.2 Children: Item: Title: Study Design, Participants, and Ethics Destination: subsection.2.1 Item: Title: Clinical Characterization Destination: subsection.2.2 Item: Title: High-Resolution CT Scan (HRCT Scan) Destination: subsection.2.3 Item: Title: Microbiology Destination: subsection.2.4 Item: Title: Data Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Blood Eosinophil Count and Follow-Up Variables Destination: subsection.3.1 Item: Title: Effects of Treatment with ICs According to the BEC Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.5 Info: Title: Bronchiectasis-COPD Overlap Syndrome: Role of Peripheral Eosinophil Count and Inhaled Corticosteroid Treatment Author: Grace Oscullo, Jose Daniel Gómez-Olivas, Marina Ingles, Sergio Mompean, Rosalia Martinez-Perez, Guillermo Suarez-Cuartin, David la Rosa-Carrillo and Miguel Angel Martinez-Garcia Subject: Both chronic obstructive pulmonary disease and bronchiectasis are highly prevalent diseases. In both cases, inhaled corticosteroids (ICs) are associated with a decrease in exacerbations in patients with a high peripheral blood eosinophil count (BEC), but it is still not known what occurs in bronchiectasis-COPD overlap syndrome (BCOS). The present study aimed to assess the effect of ICs on various outcomes in patients with BCOS, according to BEC values. We undertook a post-hoc analysis of a cohort of 201 GOLD II-IV COPD patients with a long-term follow-up (median 74 [IQR: 40 106] months). All participants underwent computerized tomography and 115 (57.2%) had confirmed BCOS. A standardized clinical protocol was followed and two sputum samples were collected at each medical visit (every 3 6 months), whenever possible. During follow-up, there were 68 deaths (59.1%), and the mean rate of exacerbations and hospitalizations per year was 1.42 (1.2) and 0.57 (0.83), respectively. A total of 44.3% of the patients presented at least one pneumonic episode per year. The mean value of eosinophils was 402 (112) eosinophils/L, with 27 (23.5%), 63 (54.8%), and 25 patients (21.7%) presenting, respectively, less than 100, 101 300, and more than 300 eosinophils/L. A total of 84 patients (73.1%) took ICs. The higher the BEC, the higher the annual rate of exacerbations and hospitalizations. Patients with less than 100 eosinophils/L presented more infectious events (incident exacerbations, pneumonic episodes, and chronic bronchial infection via pathogenic bacteria). Only those patients with eosinophilia (>300 eosinophils/L) treated with ICs decreased the number (1.77 (1.2) vs. 1.08 (0.6), p < 0.001) and the severity (0.67 (0.8) vs. 0.35 (0.5), p = 0.011) of exacerbations, without any changes in the other infectious outcomes or mortality. In conclusion, ICs treatment in patients with BCOS with increased BEC decreased the number and severity of incident exacerbations without any negative influence on other infectious outcomes (incidence of pneumonia or chronic bronchial infection). 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