Article record

追踪血嗜酸性粒细胞随时间的变化：COBRA队列中哮喘患者的长期趋势

Tracking blood eosinophils over time: long-term trends in asthmatic patients from the COBRA cohort.

临床研究鼻科IF 7.7Q1

文献信息

PMID	42759812
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Marina Gueçamburu 查看其他 11 位作者 Fanchon Herman；Joana Vitte；Isabella Annesi-Maesano；Pascal Demoly；Camille Taillé；Jesus Gonzalez-Bermejo；Pierre-Olivier Girodet；Arnaud Bourdin；Nicolas Molinari；Patrick Berger；Maéva Zysman
作者单位	CHU de Bordeaux, Service des Maladies Respiratoires, Service des Explorations Fonctionnelles Respiratoires, CIC 1401, Hôpital Haut Lévèque, Pessac, France. Electronic address: marina.guecamburu@chu-bordeaux.fr. 查看其他 8 条单位信息 Epidemiology and Clinical Research Department, CHU Montpelier, University of Montpellier, Montpellier, France.；University of Reims Champagne-Ardenne, Faculty of Medicine, INSERM UMR-S 1250 P3CELL and University Hospital of Reims, Immunology Laboratory, Reims, France.；Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy.；University Hospital of Montpellier and IDESP, University of Montpellier-INSERM-INRIA PreMediCal, Montpellier, France.；Service de Pneumologie et Centre de Référence des Maladies Pulmonaires Rares, Hôpital Bichat, UMR 1149, AP-HP Nord-Université Paris Cité, Paris, France.；AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Département R3S (Respiration, Réanimation, Réadaptation Respiratoire, Sommeil), Service de Médecine de Réadaptation Respiratoire, Paris, France.；CHU de Bordeaux, Service des Maladies Respiratoires, Service des Explorations Fonctionnelles Respiratoires, CIC 1401, Hôpital Haut Lévèque, Pessac, France; Univ-Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, Pessac, France.；PhyMedExp, University of Montpellier, CNRS, INSERM, CHU Montpellier, Montpellier, France.
期刊	The journal of allergy and clinical immunology. In practice
SCI 分区	Q1
IF	7.7
研究类型	临床研究 · 临床
所属专科	鼻科

中文摘要

背景： 在哮喘患者中，长期随访血嗜酸性粒细胞计数（BEC）可能有助于识别内型。观察性法国支气管阻塞与哮喘队列（COBRA）研究是一项纳入哮喘患者的观察性前瞻性多中心队列。
目的： 比较从入组至2±1年和5±2年时根据BEC轨迹划分的临床特征，以评估其与哮喘结局的关联。
方法： 哮喘患者于2007年1月12日至2021年2月3日期间入组。若每个时间点BEC均>300/μL，则归类为持续高；若每个时间点均<150/μL，则归类为持续低；否则为可变。根据BEC轨迹（持续低 vs 高）分析临床变量和结局。P值采用错误发现率（FDR）方法校正，P值<.05视为有统计学意义。
结果： 在全部3个时间点均有BEC数据的389例患者中，58例（15%）为持续低BEC。持续高BEC与持续低BEC患者之间，在第1秒用力呼气容积（FEV1）、根据哮喘控制问卷5的哮喘控制或急性发作方面均未观察到显著差异。42例持续高BEC患者更可能患有鼻息肉病（43% vs 5%，FDR校正P值<.01）和更高的IgE水平（中位数283 UI/mL vs 72 UI/mL，FDR校正P值<.01）。在调整年龄、性别、吸烟和体重指数后，持续高BEC与更快的FEV1下降相关（比值比3.30；95%置信区间1.17-10；P=.03）。
结论： COBRA队列中在长期随访期间持续高BEC的患者与更快的肺功能下降相关。

英文摘要

BACKGROUND: In patients with asthma, long-term follow-up of blood eosinophil count (BEC) may be useful for identifying endotypes. The observational French COhort of BRonchial obstruction and Asthma (COBRA) study is an observational prospective multicenter cohort enrolling asthmatic patients.
OBJECTIVE: To compare clinical characteristics according to BEC trajectories from inclusion to 2 ± 1 and 5 ± 2 years to assess their association with asthma outcomes.
METHODS: Asthmatic patients were enrolled between January 12, 2007, and February 3, 2021. BECs were classified as persistently high if >300/μL at each time point, persistently low if <150/μL at each time point, or variable. Clinical variables and outcomes were analyzed according of BEC trajectories (persistently low vs high). The P values were corrected using the false discovery rate (FDR) method, and P values <.05 were considered as statistically significant.
RESULTS: Among the 389 patients with BEC data available at all 3 time points, 58 (15%) had persistently low BEC. No significant differences were observed regarding forced expiratory volume in 1 second (FEV1), asthma control according to the Asthma Control Questionnaire 5, or exacerbations between patients with persistently high or low BEC. Forty-two patients with persistently high BEC were more likely to have nasal polyposis (43% vs 5%, FDR-corrected P value <.01) and higher IgE levels (median 283 UI/mL vs 72 UI/mL, FDR-corrected P value <.01). After adjustment for age, sex, smoking, and body mass index, persistently high BEC was associated with faster FEV1 decline (odds ratio, 3.30; 95% confidence interval, 1.17-10; P = .03).
CONCLUSION: Patients from the COBRA cohort with persistently high BEC across a long-term follow-up were associated with a faster lung function decline.