Low-blood lymphocyte number and lymphocyte decline as key factors in COPD outcomes: a longitudinal cohort study
Semenzato, U. ; Biondini, D. ; Bazzan, E. ; Tiné, M. ; Balestro, E. ; Buldini, B. ; Carizzo, S. J. ; Cubero, P. ; Marin-Oto, M. ; Casara, A. ; Baraldo, S. ; Turato, G. ; Gregori, D. ; Marin, J. M. (Universidad de Zaragoza) ; Cosio, M. G. ; Saetta, M.
Resumen: Background: Smokers with and without chronic obstructive pulmonary disease (COPD) are at risk of severe outcomes like exacerbations, cancer, respiratory failure, and decreased survival. The mechanisms for these outcomes are unclear; however, there is evidence that blood lymphocytes (BL) number might play a role. Objective: The objective of this study is to investigate the relationship between BL and their possible decline over time with long-term outcomes in smokers with and without COPD. Methods: In 511 smokers, 302 with COPD (COPD) and 209 without COPD (noCOPD), followed long term, we investigated whether BL number and BL decline over time might be associated with long-term outcomes. Smokers were divided according to BL number in high-BL (=1, 800 cells/µL) and low-BL (<1, 800 cells/µL). Clinical features, cancer incidence, and mortality were recorded during follow-up. BL count in multiple samples and BL decline over time were calculated and related to outcomes. Results: BL count was lower in COPD (1, 880 cells/µL) than noCOPD (2, 300 cells/µL; p < 0.001). 43% of COPD and 23% of noCOPD had low-BL count (p < 0.001). BL decline over time was higher in COPD than noCOPD (p = 0.040). 22.5% of the whole cohort developed cancer which incidence was higher in low-BL subjects and in BL decliners than high-BL (31 vs. 18%; p = 0.001) and no decliners (32 vs. 19%; p = 0.002). 26% in the cohort died during follow-up. Furthermore, low-BL count, BL decline, and age were independent risk factors for mortality by Cox regression analysis. Conclusion: BL count and BL decline are related to worse outcomes in smokers with and without COPD, which suggests that BL count and decline might play a mechanistic role in outcomes deterioration. Insights into mechanisms inducing the fall in BL count could improve the understanding of COPD pathogenesis and point toward new therapeutic measures.
Idioma: Inglés
DOI: 10.1159/000515180
Año: 2021
Publicado en: RESPIRATION 100, 7 (2021), 618-630
ISSN: 0025-7931
Factor impacto JCR: 3.966 (2021)
Categ. JCR: RESPIRATORY SYSTEM rank: 31 / 66 = 0.47 (2021) - Q2 - T2
Factor impacto CITESCORE: 6.4 - Medicine (Q1)
Factor impacto SCIMAGO: 1.084 - Pulmonary and Respiratory Medicine (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes.
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Idioma: Inglés
DOI: 10.1159/000515180
Año: 2021
Publicado en: RESPIRATION 100, 7 (2021), 618-630
ISSN: 0025-7931
Factor impacto JCR: 3.966 (2021)
Categ. JCR: RESPIRATORY SYSTEM rank: 31 / 66 = 0.47 (2021) - Q2 - T2
Factor impacto CITESCORE: 6.4 - Medicine (Q1)
Factor impacto SCIMAGO: 1.084 - Pulmonary and Respiratory Medicine (Q1)
Tipo y forma: Article (Published version)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. Exportado de SIDERAL (2023-05-18-16:06:51)
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Record created 2022-03-22, last modified 2023-05-19