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Open Access 17-06-2024 | Bronchiectasis | RESEARCH

Type 2 Biomarkers and Their Clinical Implications in Bronchiectasis: A Prospective Cohort Study

Authors: Yen-Fu Chen, Hsin-Han Hou, Ning Chien, Kai-Zen Lu, Ying-Yin Chen, Zheng-Ci Hung, Jung-Yien Chien, Hao-Chien Wang, Chong-Jen Yu

Published in: Lung

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Abstract

Purpose

Bronchiectasis is predominantly marked by neutrophilic inflammation. The relevance of type 2 biomarkers in disease severity and exacerbation risk is poorly understood. This study explores the clinical significance of these biomarkers in bronchiectasis patients.

Methods

In a cross-sectional cohort study, bronchiectasis patients, excluding those with asthma or allergic bronchopulmonary aspergillosis, underwent clinical and radiological evaluations. Bronchoalveolar lavage samples were analyzed for cytokines and microbiology. Blood eosinophil count (BEC), serum total immunoglobulin E (IgE), and fractional exhaled nitric oxide (FeNO) were measured during stable disease states. Positive type 2 biomarkers were defined by established thresholds for BEC, total IgE, and FeNO.

Results

Among 130 patients, 15.3% demonstrated BEC ≥ 300 cells/μL, 26.1% showed elevated FeNO ≥ 25 ppb, and 36.9% had high serum total IgE ≥ 75 kU/L. Approximately 60% had at least one positive type 2 biomarker. The impact on clinical characteristics and disease severity was variable, highlighting BEC and FeNO as reflective of different facets of disease severity and exacerbation risk. The combination of low BEC with high FeNO appeared to indicate a lower risk of exacerbation. However, Pseudomonas aeruginosa colonization and a high neutrophil-to-lymphocyte ratio (NLR ≥ 3.0) were identified as more significant predictors of exacerbation frequency, independent of type 2 biomarker presence.

Conclusions

Our study underscores the distinct roles of type 2 biomarkers, highlighting BEC and FeNO, in bronchiectasis for assessing disease severity and predicting exacerbation risk. It advocates for a multi-biomarker strategy, incorporating these with microbiological and clinical assessments, for comprehensive patient management.
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Metadata
Title
Type 2 Biomarkers and Their Clinical Implications in Bronchiectasis: A Prospective Cohort Study
Authors
Yen-Fu Chen
Hsin-Han Hou
Ning Chien
Kai-Zen Lu
Ying-Yin Chen
Zheng-Ci Hung
Jung-Yien Chien
Hao-Chien Wang
Chong-Jen Yu
Publication date
17-06-2024
Publisher
Springer US
Published in
Lung
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-024-00707-0
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