Type 2 inflammation may accelerate lung function decline in individuals with chronic airway diseases: Study

"For every 100 cells/µL increase in blood eosinophils and each 10 ppb rise in FeNO, FEV1 decline intensified by 1.0 mL/year and 3.2 mL/year, respectively," the researchers reported. "The most significant decline was seen in patients with asthma-like phenotypes."

There is no clarity on whether type-2 inflammation is associated with accelerated lung function decline in patients with asthma and chronic obstructive pulmonary disease (COPD). Considering this, Yunus Çolak, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark, and colleagues tested the hypothesis that type 2 inflammation indicated by elevated BE and FeNO is linked with accelerated lung function decline in the general population.

For this purpose, adults from the Copenhagen General Population Study with measurements of BE (N=15 605) and FeNO (N=2583) were included in a follow-up examination and assessed FEV1 decline in the preceding 10 years. Participants were assigned as not having airway disease, asthma with full reversibility (AR), COPD, asthma with persistent obstruction (APO), and not classifiable airflow limitation (NAL) based on pre-and post-bronchodilator lung function, smoking history and asthma at follow-up examination.

Based on the study, the researchers reported the following findings:

• FEV1 decline in mL/year increased with 1.0 per 100 cells/µL higher BE and with 3.2 per 10 ppb higher FeNO.
• Adjusted FEV1 decline in mL/year was 18 in those with BE<300 cells/µL and FeNO<20 ppb, 22 in BE≥300 cells/µL or FeNO≥20 ppb, and 27 in those with BE≥300 cells/µL and FeNO≥20 ppb.
• Corresponding FEV1 declines were 24, 33 and 44 in AR, 26, 36 and 56 in APO, 32, 31 and 44 in COPD, and 27, 35, and 37 in NAL, respectively.

"Type-2 inflammation marked by elevated BE and FeNO is associated with accelerated FEV1 decline in patients with chronic airway disease in the general population," the researchers wrote, adding that, "this association was most pronounced in an asthma-like phenotype."

Reference:

Çolak Y, Afzal S, Marott JL, et alType-2 inflammation and lung function decline in chronic airway disease in the general populationThorax Published Online First: 09 January 2024. doi: 10.1136/thorax-2023-220972