EOSINOPHILIC CATION PROTEIN AS A SENSITIVE BIOMARKER OF EOSINOPHILIC INFLAMMATION AND A PREDICTOR OF SEVERE COPD

It has been established that the eosinophilic phenotype of COPD is separate phenotype of the disease. The results of some studies demonstrate the possibility that may presence a phenotype with an increased level of eosinophil activity. To study the relationship between the blood ECP level and the characteristics of the course of COPD, we examined 161 patients with COPD aged from 40 to 70 years old, smoking index> 10 pack-years, no history of atopy, total blood Ig E <100 IU / ml. The following assessments was made: the severity of dyspnea on the mMRC scale, assessment of the degree of purulent sputum, the level of blood eosinophils, the level of ECP of the blood, whole-body plethysmograph, chest CT. Patients were stratified by the level of blood eosinophils (≥300 cells/μl, <300 cells/μl), by the level of ECP (≥24 ng/ml, <24 ng/ml), and by the level of blood eosinophils ≥100 cells/μL in combination with ≥2 moderate exacerbations or hospitalization per year. Comparative analysis showed that patients with ECP ≥24 ng/ml had a higher mMRC score and a higher BODE index, they developed exacerbations and pneumonia more often, ICS was prescribed more often, and signs of static hyperinflation were more pronounced. In patients with ECP <24 ng/ml, purulent sputum separation was more often detected, and antibiotics were prescribed more often. Similar data were obtained with stratification by the level of eosinophils in the blood> 100 cells/μL in combination with ≥2 exacerbations of moderate or severe severity during the year, but not with stratification by the level of blood eosinophils (≥300 cells/μL, <300 cells/μL). It has been shown that an increase in ECP in accordance with moderate and severe exacerbations is a more reliable markers of the development of the eosinophilic phenotype in patients with COPD.