Evidence map›Paper›PMID 29146301›Full record

Observational studyThe Lancet. Respiratory medicine2017

Association of sputum and blood eosinophil concentrations with clinical measures of COPD severity: an analysis of the SPIROMICS cohort.

Annette T Hastie, Fernando J Martinez, Jeffrey L Curtis, Claire M Doerschuk, Nadia N Hansel, Stephanie Christenson, Nirupama Putcha, Victor E Ortega, Xingnan Li, R Graham Barr and 15 more

Registry-linked trialOpen access · greenAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Lancet. Respiratory medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01969344 (Subpopulations and Intermediate Outcome Measures in COPD Study), which is not on this map. Cited by 169 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
169citing papers in PubMed, 5 pooled it
21.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01969344 active not recruitingnot on this map

Subpopulations and Intermediate Outcome Measures in COPD Study

TypeobservationalSponsorUniversity of North Carolina, Chapel HillRan2010 to 2031Enrolled2,981ConditionsCOPD, Chronic Obstructive Pulmonary Disease, Chronic Bronchitis, Emphysema
3 · Its place in the literature

Who cites it

169 citing papers in PubMed, 5 syntheses or guidelines pooled it, 313 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Mepolizumab in the treatment of eosinophilic chronic obstructive pulmonary disease.International journal of chronic obstructive pulmonary disease · 2019
    Pooled it
  4. Pooled it
  5. Blood eosinophils and inhaled corticosteroids in patients with COPD: systematic review and meta-analysis.International journal of chronic obstructive pulmonary disease · 2018
    Pooled it
  6. Trial
  7. Trial
  8. Trial
  9. Trial
  10. Preclinical models of COPD: a state of the art review.The European respiratory journal · 2026
    Review
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Review

109 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

25 authors at 13 institutions in 1 country.

Annette T HastieWake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: ahastie@wakehealth.edu.
Fernando J MartinezWeill Cornell Medical College of Cornell University, New York, NY, USA.
Jeffrey L CurtisVA Ann Arbor Healthcare System, Ann Arbor, MI, USA; University of Michigan, Ann Arbor, MI, USA.
Claire M DoerschukUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.
Nadia N HanselJohns Hopkins University, Baltimore, MD, USA.
Stephanie ChristensonUniversity of California San Francisco, San Francisco, CA, USA.
Nirupama PutchaJohns Hopkins University, Baltimore, MD, USA.
Victor E OrtegaWake Forest School of Medicine, Winston-Salem, NC, USA.
Xingnan LiUniversity of Arizona College of Medicine, Tucson, AZ, USA.
R Graham BarrColumbia University/Presbyterian Hospital, New York, NY, USA.
Elizabeth E CarrettaUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
David J CouperUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Christopher B CooperDavid Geffen School of Medicine, Los Angeles, CA, USA.
Eric A HoffmanUniversity of Iowa, Iowa City, IA, USA.
Richard E KannerUniversity of Utah Health Sciences Center, Salt Lake City, UT, USA.
Eric KleerupDavid Geffen School of Medicine, Los Angeles, CA, USA.
Wanda K O'NealUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.
Richard PaineUniversity of Utah Health Sciences Center, Salt Lake City, UT, USA; Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA.
Stephen P PetersWake Forest School of Medicine, Winston-Salem, NC, USA.
Neil E AlexisUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Prescott G WoodruffUniversity of California San Francisco, San Francisco, CA, USA.
MeiLan K HanUniversity of Michigan, Ann Arbor, MI, USA.
Deborah A MeyersUniversity of Arizona College of Medicine, Tucson, AZ, USA.
Eugene R BleeckerUniversity of Arizona College of Medicine, Tucson, AZ, USA.
SPIROMICS investigators
University of North Carolina at Chapel Hill · USUniversity of Arizona · USJohns Hopkins University · USUniversity of California, San Francisco · USWake Forest University · USUniversity of Utah · USCornell University · USUniversity of Iowa · USUniversity of Michigan–Ann Arbor · USVA Ann Arbor Healthcare System · USColumbia University · USPresbyterian Hospital · USVeterans Health Administration · US

Funding

Pulmonary Toxicology Facility CoreP30ES005605 · NIEHS · UNIVERSITY OF IOWA · PI HANS-JOACHIM LEHMLER · 1990 to 2026
$40.5M
SPIROMICS II: Biological underpinnings of COPD heterogeneity and progressionU01HL137880 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WOODRUFF, PRESCOTT G · 2017 to 2021
$27.9M
Parametric Response Mapping in COPDR01HL122438 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HAN, MEILAN K, MARTINEZ, FERNANDO J · 2014 to 2017
$4.0M
Mentoring Research in Precision Medicine for Lung DiseaseK24HL137013 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI PRESCOTT G WOODRUFF · 2017 to 2026
$1.2M
The association of allergic disease with clinical outcomes in COPD.K23HL123594 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI PUTCHA, NIRUPAMA · 2015 to 2019
$1.0M
Identifying the Th2 endotype in COPD: clinical and pathologic implicationsK23HL123778 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CHRISTENSON, STEPHANIE A · 2015 to 2019
$847k
Hypercoagulability and Chronic Lung Disease in Older AdultsK23HL130627 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI OELSNER, ELIZABETH · 2016 to 2019
$686k
Modulation of Steroid Suppression by Alveolar Macrophage EfferocytosisI01CX000911 · VA · VETERANS HEALTH ADMINISTRATION · PI CURTIS, JEFFREY LOUIS · 2016 to 2020
–
CSRD VA I01 CX000911NHLBI NIH HHS HHSN268200900013CNHLBI NIH HHS HHSN268200900014CNHLBI NIH HHS HHSN268200900015CNHLBI NIH HHS HHSN268200900016CNHLBI NIH HHS HHSN268200900017CNHLBI NIH HHS HHSN268200900018CNHLBI NIH HHS HHSN268200900019CNHLBI NIH HHS HHSN268200900020CNHLBI NIH HHS K23 HL123594NHLBI NIH HHS K23 HL123778NHLBI NIH HHS K23 HL130627NHLBI NIH HHS K24 HL137013NHLBI NIH HHS R01 HL122438NHLBI NIH HHS U01 HL137880NIEHS NIH HHS P30 ES005605
6 · The paper itself

Abstract

backgroundIncreased concentrations of eosinophils in blood and sputum in chronic obstructive pulmonary disease (COPD) have been associated with increased frequency of exacerbations, reduced lung function, and corticosteroid responsiveness. We aimed to assess whether high eosinophil concentrations in either sputum or blood are associated with a severe COPD phenotype, including greater exacerbation frequency, and whether blood eosinophils are predictive of sputum eosinophils.

methodsWe did a multicentre observational study analysing comprehensive baseline data from SPIROMICS in patients with COPD aged 40-80 years who had a smoking history of at least 20 pack-years, recruited from six clinical sites and additional subsites in the USA between Nov 12, 2010, and April 21, 2015. Inclusion criteria for this analysis were SPIROMICS baseline visit data with complete blood cell counts and, in a subset, acceptable sputum counts. We stratified patients on the basis of blood and sputum eosinophil concentrations and compared their demographic characteristics, as well as results from questionnaires, clinical assessments, and quantitative CT (QCT). We also analysed whether blood eosinophil concentrations reliably predicted sputum eosinophil concentrations. This study is registered with ClinicalTrials.gov (NCT01969344).

findingsOf the 2737 patients recruited to SPIROMICS, 2499 patients were smokers and had available blood counts, and so were stratified by mean blood eosinophil count: 1262 patients with low (<200 cells per μL) and 1237 with high (≥200 cells per μL) blood eosinophil counts. 827 patients were eligible for stratification by mean sputum eosinophil percentage: 656 with low (<1·25%) and 171 with high (≥1·25%) sputum eosinophil percentages. The high sputum eosinophil group had significantly lower median FEV

interpretationIn a large, well characterised cohort of former and current smoking patients with a broad range of COPD severity, high concentrations of sputum eosinophils were a better biomarker than high concentrations of blood eosinophils to identify a patient subgroup with more severe disease, more frequent exacerbations, and increased emphysema by QCT. Blood eosinophils alone were not a reliable biomarker for COPD severity or exacerbations, or for sputum eosinophils. Clinical trials targeting eosinophilic inflammation in COPD should consider assessing sputum eosinophils.

fundingNational Institutes of Health, and National Heart, Lung, and Blood Institute.

Indexed as

EosinophilsSeverity of Illness IndexAdrenal Cortex HormonesAgedBiomarkersBronchodilator AgentsFemaleForced Expiratory VolumeHumansLeukocyte CountLungMaleMiddle AgedPulmonary Disease, Chronic ObstructiveROC CurveSputumAdrenal Cortex HormonesBiomarkersBronchodilator Agents

Identifiers

PMID29146301
PMCPMC5849066
OpenAlexW2770113020

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.