{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T18:05:04Z","timestamp":1770919504388,"version":"3.50.1"},"reference-count":35,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T00:00:00Z","timestamp":1513555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T00:00:00Z","timestamp":1513555200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2018]]},"abstract":"<b><i>Background:<\/i><\/b> \u03b1<sub>1<\/sub>-Antitrypsin deficiency (AATD) predisposes to chronic obstructive pulmonary disease (COPD). In COPD unrelated to AATD, the role of a higher blood eosinophil count in disease and subsequent personalization of therapy has recently received much attention. We sought to investigate this concept in patients with AATD-associated COPD. <b><i>Objectives:<\/i><\/b> The study aims to evaluate eosinophilia status against outcomes including mortality and FEV<sub>1<\/sub> decline in patients with AATD. <b><i>Methods:<\/i><\/b> All patients with PiSZ and PiZZ genotypes were identified from the UK AATD registry. The participants were substratified according to inhaled corticosteroid (ICS) use. Blood eosinophil counts were assessed from baseline and annually during follow-up (range 1\u201318 years). Eosinophilia was defined as a level &#x3e;0.2 \u00d7 10<sup>9<\/sup>\/L, and classified by the frequency of such counts into \u201calways,\u201d \u201cintermittent,\u201d or \u201cnever present.\u201d Univariate and multivariate analyses were conducted. <b><i>Results:<\/i><\/b> In total, 646 participants were included, 53.9% of whom demonstrated intermittent and 7.4% persistent eosinophilia. Survival did not differ according to eosinophilic group (<i>p<\/i> &#x3e; 0.05). Those with persistent eosinophilia showed a slower FEV<sub>1<\/sub> decline (<i>p<\/i> &#x3c; 0.001). There was no clear association with exacerbation frequency. Patients on ICS at baseline were more likely to be eosinophilic (<i>p<\/i> = 0.002) and having a lower FEV<sub>1<\/sub> (<i>p<\/i> &#x3c; 0.001) and greater pack-year exposure (16.5 vs. 7.8 pack-years, <i>p<\/i> &#x3c; 0.001). When the multivariate analyses of FEV<sub>1<\/sub> decline were stratified for baseline ICS use, the association of persistent eosinophilia with slower decline persisted in those on ICS. <b><i>Conclusions:<\/i><\/b> Blood eosinophil levels persistently &#x3e;0.2 \u00d7 10<sup>9<\/sup>\/L may be an indication for ICS use in PiZZ AATD in order to reduce FEV<sub>1<\/sub> decline.<\/jats:p>","DOI":"10.1159\/000481867","type":"journal-article","created":{"date-parts":[[2017,12,18]],"date-time":"2017-12-18T22:07:47Z","timestamp":1513634867000},"page":"114-121","source":"Crossref","is-referenced-by-count":9,"title":["ICS Use May Modify FEV<sub>1<\/sub> Decline in \u03b1<sub>1<\/sub>-Antitrypsin Deficiency Patients with Relatively High Blood Eosinophils"],"prefix":"10.1159","volume":"95","author":[{"given":"Emma\u00a0V.","family":"Low","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Si\u00e2n\u00a0M.","family":"Hughes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safia","family":"Zaffarullah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitris","family":"Kantas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert\u00a0Andrew","family":"Stockley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice\u00a0M.","family":"Turner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2017,12,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.154690"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.00009014"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2013.11.006"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2015-206906"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2006.00784.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.150.6.7952628"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02872-5"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.7.643"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.5.9804028"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.3.9909064"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1177\/2040622315609251"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201108-1553OC"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01370-2015"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00106-X"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201502-0235LE"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2009.09.004"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-13-16"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00087908"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-6-152"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201311-380OC"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2009.047589"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201104-0597OC"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2011.12.009"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2009.04.004"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.152.6.8520756"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00061208"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00162414"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-8-149"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S111508"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00162811"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-1055"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/S0954-6111(97)90030-5"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00016908"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063070"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(13)70040-7"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/481867","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/481867","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:05:41Z","timestamp":1745427941000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000481867"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,18]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2018,2,13]]},"published-print":{"date-parts":[[2018,2,12]]}},"URL":"https:\/\/doi.org\/10.1159\/000481867","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.5712160","asserted-by":"subject"}]},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,18]]}}}