Abstract
There is growing interest in blood eosinophil counts in the management of chronic respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Despite this, typical blood eosinophil levels in the general population, and the impact of potential confounders on these levels have not been clearly defined.
We measured blood eosinophil counts in a random sample of 11 042 subjects recruited from the general population in Austria. We then: 1) identified factors associated with high blood eosinophil counts (>75th percentile); and 2) excluded subjects with these factors to estimate median blood eosinophil counts in a “healthy” sub-population (n=3641).
We found that: 1) in the entire cohort, age ≤18 years (OR 2.41), asthma (OR 2.05), current smoking (OR 1.72), positive skin prick test (OR 1.64), COPD (OR 1.56), metabolic syndrome (OR 1.41), male sex (OR 1.36) and obesity (OR 1.16) were significantly (p<0.05) associated with high blood eosinophil counts (binary multivariable logistic regression analysis), and had an additive effect; and 2) after excluding these factors, in those older than 18 years, blood eosinophil counts were higher in males than in females (median 120 (5%–95% CI: 30–330) versus 100 (30–310) cells·µL−1, respectively) and did not change with age.
Median blood eosinophil counts in adults are considerably lower than those currently regarded as normal, do not change with age beyond puberty, but are significantly influenced by a variety of factors which have an additive effect. These observations will contribute to the interpretation of blood eosinophil levels in clinical practice.
Abstract
The level of circulating blood eosinophils in healthy subjects is much lower than currently considered, is age dependent until 18 years, is higher in males and is influenced by several multimorbid conditions and lifestyle factors http://bit.ly/37W7EDd
Footnotes
This article has an editorial commentary: https://doi.org/10.1183/13993003.00473-2020
This study is registered at ClinicalTrials.gov with identifier NCT01727518. Data availability: as this is an ongoing longitudinal cohort study, open access data will not be provided. Methodology and the hypothesis are published in J Epidemiol 2019; 29: 315–324. Study protocol is published at clinical trials.gov (NCT01727518). Data from the database are shared with CADSET (chronic airway disease early stratification): a new ERS clinical research collaboration initiative in collaborative projects and on request for specific research questions after approval of the research consortium of LEAD. Requests can be submitted to office@leadstudy.at
Conflict of interest: S. Hartl has received unrestricted research grants for the Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology and is on advisory boards for GSK, Boehringer Ingelheim, Novartis, Menarini, Chiesi, AstraZeneca, MSD, Roche, Abbvie, Takeda and TEVA for respiratory oncology and COPD.
Conflict of interest: M-K. Breyer reports unrestricted grants for the LEAD study from GlaxoSmithKline, Novartis Pharma, AstraZeneca, Chiesi Pharma, Menarini Pharma, TEVA Ratiopharm, MSD, Air Liquide Health Care, Pfizer Corporation, Boehringer Ingelheim and Mundipharma.
Conflict of interest: O.C. Burghuber reports grants from Boehringer Ingelheim, GSK, AstraZeneca, Menarini, Teva, Pfizer, Chiesi, Federal State Goverment Dept of Health and Novartis, non-financial support from AirLiquid and Municipial Dept of Health in Vienna, during the conduct of the study; personal fees for advisory board work and lectures from Boehringer Ingelheim, AstraZeneca, Chiesi, MSD, Menarini and Roche, personal fees for advisory board work from GSK, outside the submitted work.
Conflict of interest: A. Ofenheimer has nothing to disclose.
Conflict of interest: A. Schrott has nothing to disclose.
Conflict of interest: M.H. Urban reports grants from Nycomed Pharma, during the conduct of the study; personal fees for lectures and advisory board work from AstraZeneca and Boehringer Ingelheim, outside the submitted work.
Conflict of interest: A. Agusti reports personal fees from AstraZeneca, Chiesi and Nuvaira, grants and personal fees from Menarini and GSK, outside the submitted work.
Conflict of interest: M. Studnicka reports personal fees for consultancy from Chiesi, AstraZeneca, Novartis, Boehringer and Almirall, and personal fees for lectures from GSK, AstraZeneca, Almirall, Novartis and Boehringer, outside the submitted work.
Conflict of interest: E.F.M. Wouters reports personal fees for advisory board work from Nycomed and Boehringer, grants from AstraZeneca and GSK, personal fees for lectures from AstraZeneca, Novartis, GSK and Chiesi, outside the submitted work.
Conflict of interest: R. Breyer-Kohansal reports personal fees for presentations and/or participations for AstraZeneca, Boehringer Ingelheim, Chiesi and Novartis outside the submitted work.
Support statement: This work was supported by The Municipal Department of Health and Environment of Vienna, the Federal State Governmental Department of Health of Lower Austria, the Ludwig Boltzmann Society, unrestricted scientific grants from GlaxoSmithKline, Novartis Pharma, AstraZeneca, Chiesi Farmaceutici SpA, Menarini Pharma, Teva, MSD, Air Liquide Health Care, Pfizer and Boehringer Ingelheim. None of the supporting parties has any participation in the data, nor have they contributed to the design or the content of the manuscript.
- Received September 20, 2019.
- Accepted January 28, 2020.
- Copyright ©ERS 2020