Phenotypic Clustering in Non-Cystic Fibrosis Bronchiectasis Patients: The Role of Eosinophils in Disease Severity

Xuejie Wang, Carmen Villa, Yadira Dobarganes, Casilda Olveira, Rosa Girón, Marta García-Clemente, Luis Máiz, Oriol Sibila, Rafael Golpe, Rosario Menéndez, Juan Rodríguez-López, Concepción Prados, Miguel Angel Martinez-García, Juan Luis Rodriguez, David de la Rosa, Xavier Duran, Jordi Garcia-Ojalvo and Esther Barreiro
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Xuejie Wang: Lung Cancer and Muscle Research Group, Pulmonology Department, Hospital del Mar-IMIM, Parc de Salut Mar, 08003 Barcelona, Spain
Carmen Villa: Respiratory Department, Clínica Fuensanta, 28027 Madrid, Spain
Yadira Dobarganes: Respiratory Department, Clínica Fuensanta, 28027 Madrid, Spain
Casilda Olveira: Respiratory Department, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, 29010 Málaga, Spain
Rosa Girón: Respiratory Department, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, 28006 Madrid, Spain
Marta García-Clemente: Respiratory Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
Luis Máiz: Respiratory Department, Hospital Ramon y Cajal, 28034 Madrid, Spain
Oriol Sibila: Respiratory Department, Hospital Clínic, 08036 Barcelona, Spain
Rafael Golpe: Respiratory Department, Hospital Lucus Augusti, 27003 Lugo, Spain
Rosario Menéndez: Respiratory Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
Juan Rodríguez-López: Respiratory Department, Hospital San Agustin, Avilés, 33401 Asturias, Spain
Concepción Prados: Respiratory Department, Hospital la Paz, 28046 Madrid, Spain
Miguel Angel Martinez-García: Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
Juan Luis Rodriguez: Respiratory Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, 28040 Madrid, Spain
David de la Rosa: Respiratory Department, Hospital Santa Creu I Sant Pau, 08041 Barcelona, Spain
Xavier Duran: Scientific and Technical Department, Hospital del Mar-IMIM, 08003 Barcelona, Spain
Jordi Garcia-Ojalvo: Department of Health and Experimental Sciences (CEXS), Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
Esther Barreiro: Lung Cancer and Muscle Research Group, Pulmonology Department, Hospital del Mar-IMIM, Parc de Salut Mar, 08003 Barcelona, Spain

IJERPH, 2021, vol. 18, issue 16, 1-16

Abstract: Whether high blood eosinophil counts may define a better phenotype in bronchiectasis patients, as shown in chronic obstructive pulmonary disease (COPD), remains to be investigated. Differential phenotypic characteristics according to eosinophil counts were assessed using a biostatistical approach in a large cohort study from the Spanish Online Bronchiectasis Registry (RIBRON). The 906 patients who met the inclusion criteria were clustered into two groups on the basis of their eosinophil levels. The potential differences according to the bronchiectasis severity index (BSI) score between two groups (Mann–Whitney U test and eosinophil count threshold: 100 cells/µL) showed the most balanced cluster sizes: above-threshold and below-threshold groups. Patients above the threshold exhibited significantly better clinical outcomes, lung function, and nutritional status, while showing lower systemic inflammation levels. The proportion of patients with mild disease was higher in the above-threshold group, while the below-threshold patients were more severe. Two distinct clinical phenotypes of stable patients with non-cystic fibrosis (CF) bronchiectasis of a wide range of disease severity were established on the basis of blood eosinophil counts using a biostatistical approach. Patients classified within the above-threshold cluster were those exhibiting a mild disease, significantly better clinical outcomes, lung function, and nutritional status while showing lower systemic inflammatory levels. These results will contribute to better characterizing bronchiectasis patients into phenotypic profiles with their clinical implications.

Keywords: non-cystic fibrosis bronchiectasis; eosinophil counts; biostatistical analyses; multivariate analyses; clinical outcomes; phenotypic clusters; disease severity scores (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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