Page 26 - Livre électronique des Rencontres Franco-Tunisiennes de Pneumologie 2019

P2. BLOOD EOSINOPHILIA FOR PHENOTYPING EOSINOPHILIC ASTHMA: WHICH
CRITERION TO CHOOSE?

FATMA GUEZGUEZ1,2, INÈS GHANNOUCHI1,2, WAFA BENZARTI3, ICHRAF ANANE1, AMANI
SAYHI1, AMEL GABSI1, KHALED CHABBAH4, MONDHER KORTAS5, SONIA ROUATBI1,2
1: DEPARTMENT OF PHYSIOLOGY AND FUNCTIONAL EXPLORATIONS, UNIVERSITY HOSPITAL OF FARHAT HACHED, SOUSSE,
TUNISIA 2: HEART FAILURE (LR12SP09) RESEARCH LABORATORY, UNIVERSITY HOSPITAL OF FARHAT HACHED, SOUSSE,
TUNISIA 3: DEPARTMENT OF PNEUMOLOGY, UNIVERSITY HOSPITAL OF FARHAT HACHED, SOUSSE, TUNISIA 4: LABORATORY
OF HISTOLOGY AND EMBRYOLOGY, UNIVERSITY HOSPITAL OF FARHAT HACHED, SOUSSE, TUNISIA 5: LABORATORY OF
HAEMATOLOGY, UNIVERSITY HOSPITAL OF FARHAT HACHED, SOUSSE, TUNISIA

Introduction

The study of blood inflammatory pattern is an easy, lower cost, accessible and well-tolerated
method for phenotyping asthma as eosinophilic one. Eosinophilic inflammatory pattern is a risk
factor for poor asthma outcomes. However, there is no consensus about the cut off level for Blood
eosinophilia (BEo). The main reported cut-off levels were 300 and 400 cells/µl. Furthermore, a new
approach using a composite index that uses eosinophil/lymphocyte ratio and
eosinophil/neutrophil ratio, called ELEN index, has been advanced as a better surrogate for
eosinophilic asthma.

Aim to determine which of the BEo at 300 , 400 cells/µl or the ELEN index is a better surrogate for
eosinophilic asthma and associated with poor asthma outcomes.

Methods
It is a cross sectional study including 102 subjects with asthma. A medical questionnaire assessing
asthma outcomes (symptoms control, severe exacerbations with hospitalization in the previous
year), a spirometry with bronchodilator test and a measurement of the bronchial nitric oxide (FeNO)
were performed. Complete peripheral blood counts were determined. Eosinophilic (Eo+) and non
eosinophilic (Eo-) were identified using the aforementioned three definitions. Statistical analysis
was performed using STATISTICA software. p0.05 was significant.

Results
The sample was aged 44.3±13.3 years and it was female dominated (70.6%). The eosinophilic
pattern was present in 29, 41 and 39% using the 300, 400 cut-offs and ELEN index, respectively.

• Using the three criteria, the Eo+ group had higher FeNO levels, a valid biomarker for
bronchial eosinophilic inflammation.

• Using the ELEN index but not the 300 and 400 cut-off levels, the Eo+ group had an impaired
lung function compared to the Eo- one, as shown by a reduced FEV1 (62±15 vs 69±16,
p=0.032 ) and more proximal obstructive ventilatory defect (66.7% vs 37.7%, p=0.029).

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