Association of Blood Eosinophilia with Disease Severity and Clinical Outcomes in Bronchiectasis = 기관지확장증에서 혈중 호산구 증가와 질병 중증도 및 임상 경과와의 연관성|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Bronchiectasis is a heterogeneous chronic airway disease with variable inflammatory profiles and clinical outcomes. Although neutrophilic inflammation predominates, eosinophilic inflammation has been identified in a subset of patients. However, the clinical significance of blood eosinophilia in bronchiectasis remains unclear, particularly regarding disease severity, longitudinal lung-function changes, and exacerbation risk. We analyzed data from the Korean Multicenter Bronchiectasis Audit and Research Collaboration （KMBARC）, a prospective multicenter cohort of non-cystic fibrosis bronchiectasis. Patients were classified as having eosinophilia if blood eosinophil counts were ≥300 cells/μL at any point during a 3-year follow-up period. Baseline clinical, radiologic, pulmonary-function, symptom, and severity-index data were compared between patients with and without eosinophilia. Longitudinal changes in lung function and dyspnea were evaluated using mixed-effects models, and associations between eosinophilia and severe exacerbation outcomes were assessed using multivariable regression analyses.
Among 832 patients, 158 （19.0%） demonstrated eosinophilia. Compared with patients without eosinophilia, those with eosinophilia showed greater radiologic extent, higher dyspnea scores, and higher baseline severity indices, including BSI, FACED, and E-FACED. Baseline FEV₁ （% predicted） was lower in the eosinophilia group; however, the rate of longitudinal FEV₁ decline over 3 years did not differ significantly between groups. In contrast, dyspnea severity worsened more prominently over time among patients with eosinophilia. Eosinophilia was associated with increased hospitalization risk in models without adjustment for disease severity, but this association was attenuated after adjustment for the Bronchiectasis Severity Index. Eosinophilia was not independently associated with emergency department visits.
In conclusion, blood eosinophilia identifies a bronchiectasis subgroup with greater symptom burden and disease severity. However, eosinophilia was not independently associated with accelerated lung-function decline or severe exacerbation risk after adjustment for baseline disease severity.

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목차 (Table of Contents)

Chatper 1 Introduction 1
Chatper 2 Methods 2
2.1 Participants
2.2 Definition of eosinophilia
2.3 Baseline clinical, microbiologic, and radiologic variables

Chatper 1 Introduction 1
Chatper 2 Methods 2
2.1 Participants
2.2 Definition of eosinophilia
2.3 Baseline clinical, microbiologic, and radiologic variables
2.4 Pulmonary function and symptom assessment
2.5 Exacerbations, disease severity, and patient-reported outcomes
2.6 Statistical analysis
Chatper 3 Results 4
3.1 Baseline characteristics of the study population
3.2 Longitudinal pulmonary function and dyspnea outcomes
3.3 Clinical outcomes and bronchiectasis severity indices
3.4 Multivariable analysis of factors associated with hospitalization risk
3.5 Missing data and sensitivity analysis
Chapter 4 Discussion 15

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Association of Blood Eosinophilia with Disease Severity and Clinical Outcomes in Bronchiectasis = 기관지확장증에서 혈중 호산구 증가와 질병 중증도 및 임상 경과와의 연관성

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