Chronic obstructive pulmonary disease (COPD) is a heterogeneous inflammatory disease and eosinophils (EOS) participate in inflammation process. Acute exacerbation of COPD (AECOPD) is an inevitable trend in the development of the disease and has attracted widespread attention. In the present study, 108 hospitalized patients with AECOPD were collected and the levels of interleukin-13 and eosinophil cationic protein in the serum and sputum were measured to explore their clinical value in eosinophilic AECOPD patients. The patients were divided into an eosinophilic group (52 cases, 48.15%) and a noneosinophilic group (56 cases, 51.85%). The eosinophilic group had fewer acute exacerbations in the past year, shorter average hospitalization days, lower respiratory failure rate, mechanical ventilation utilization rate, and lower CAT and mMRC scores (P < 0.05). The levels of interleukin-13 and eosinophil cationic protein in sputum in the eosinophilic group were higher than those in the noneosinophilic group (P < 0.05), and there was no significant difference in the serum between the two groups (P > 0.05). The receiver operating characteristic (ROC) curves of sputum interleukin-13 and eosinophil cationic protein predicting peripheral blood EOS% ≥2% of AECOPD patients were statistically significant (P < 0.05). The noneosinophilic group had a higher rate of rehospitalization due to acute exacerbation during the one-year follow-up, and there was no significant difference in mortality between the two groups. The results show that eosinophils in peripheral blood are a simple, convenient, and inexpensive index for assessing the condition and prognosis of AECOPD patients. Interleukin-13 and eosinophil cationic protein are involved in the pathogenesis of eosinophilic AECOPD and may be the new targeted anti-inflammatory therapies in the future.

Impact statement

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an inevitable trend in the development of the disease and eosinophils (EOS) participate in inflammation process. It is important to explore some relatively simple biomarkers in AECOPD which are useful to recognize the disease. In the present study, 108 hospitalized patients with AECOPD were collected and the levels of IL-13 and ECP in the serum and sputum were measured. The levels of IL-13 and ECP in sputum in the eosinophilic group were higher than those in the noneosinophilic group. Moreover, the noneosinophilic group had a higher rate of rehospitalization due to acute exacerbation during the one-year follow-up. The results show that eosinophils in peripheral blood are a simple, convenient, and inexpensive index for assessing the condition and prognosis of AECOPD patients. IL-13 and ECP are involved in the pathogenesis of eosinophilic AECOPD and may be the new targeted anti-inflammatory therapies.

中文翻译：

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嗜酸性AECOPD患者血清和痰中IL-13和ECP的临床价值

慢性阻塞性肺疾病（COPD）是一种异质性炎症性疾病，嗜酸性粒细胞（EOS）参与炎症过程。COPD急性加重（AECOPD）是疾病发展的必然趋势，已引起广泛关注。本研究收集了 108 例 AECOPD 住院患者，检测血清和痰中白细胞介素 13 和嗜酸性粒细胞阳离子蛋白水平，探讨其在嗜酸性 AECOPD 患者中的临床价值。患者分为嗜酸性粒细胞组（52例，48.15%）和非嗜酸性粒细胞组（56例，51.85%）。嗜酸性粒细胞组过去一年急性加重较少，平均住院天数较短，呼吸衰竭率、机械通气利用率较低，CAT和mMRC评分较低。P  <  0.05)。嗜酸性粒细胞组痰中白细胞介素13和嗜酸性粒细胞阳离子蛋白水平高于非嗜酸性粒细胞组（P  <  0.05），两组血清比较差异无统计学意义（P  >  0.05）。预测AECOPD患者外周血EOS%≥2%的痰白细胞介素-13和嗜酸性粒细胞阳离子蛋白的受试者工作特征（ROC）曲线有统计学意义（P  < 0.05）。非嗜酸性粒细胞组在一年随访期间因急性加重而再入院率较高，两组死亡率无显着差异。结果表明外周血嗜酸性粒细胞是评估AECOPD患者病情和预后的简单、方便、廉价的指标。白细胞介素13和嗜酸性粒细胞阳离子蛋白参与嗜酸性AECOPD的发病机制，可能成为未来新的靶向抗炎治疗。

影响陈述

慢性阻塞性肺疾病急性加重（AECOPD）是疾病发展的必然趋势，嗜酸性粒细胞（EOS）参与炎症过程。在 AECOPD 中探索一些相对简单的生物标志物非常重要，它们有助于识别疾病。本研究收集了 108 名住院 AECOPD 患者，并测量了血清和痰中 IL-13 和 ECP 的水平。嗜酸性粒细胞组痰中IL-13和ECP水平高于非嗜酸性粒细胞组。此外，由于在一年的随访期间急性加重，非嗜酸性粒细胞组的再住院率更高。结果表明外周血嗜酸性粒细胞是评估AECOPD患者病情和预后的简单、方便、廉价的指标。