Betydningen af type 2-inflammation*
* Type 2 inflammation hos KOL er defineret ved forhøjet biomarkør. (Eosinofile celler i blodet >300 µL eller >2% eller eosinofile celler i sputum på > 3%)
Type 2 inflammation* kan øge risikoen for eksacerbationer samt lungefunktionsnedsættelse ved KOL4,16
KOL er karakteriseret ved slimproduktion, luftvejsobstruktion og hoste1
Inflammationen manifesterer sig systemisk og lokalt
- Kronisk inflammation resulterer i strukturelle forandringer, herunder forsnævring af luftvejene og nedsat lungeelasticitet1
- Studier har påvist en sammenhæng mellem inflammation og slimhypersekretion ved luftvejssygdomme såsom KOL14
* Type 2 inflammation hos KOL er defineret ved forhøjet biomarkør. (Eosinofile celler i blodet >300 µL eller >2% eller eosinofile celler i sputum på > 3%)
Se efter forhøjede eosinofile celletal i blodet (>300 celler/μL) - en biomarkør for type 2 inflammation* ved KOL1
Forhøjet eosinofile celletal i blodet hos KOL-patienter, er en "treatable trait" og markør for type 2 inflammation*1
GOLD reporten fra 2024 anerkender eosinofile celletal i blodet, som en klinisk relevant biomarkør til at identificere KOL med type 2 inflammation*.1
Type 2 inflammation* ved KOL kan involvere flere pathways, cytokiner, og inflammatoriske celler18-23
IL-4, IL-13 og IL-5 er alle type 2 cytokiner som spiller en rolle i KOL
* Type 2 inflammation hos KOL er defineret ved forhøjet biomarkør. (Eosinofile celler i blodet >300 µL eller >2% eller eosinofile celler i sputum på > 3%)
aEn alvorlig eksacerbation blev defineret som en indlæggelse på grund af KOL. Eksacerbationerne skulle være med mindst 4 ugers mellemrum for at blive betragtet som separate eksacerbationer.27
bI en kohorte af patienter med EOS >200 celler/μL.26
cGengivet med tilladelse fra the American Thoracic Society. Fritzsching B et al. Am J Respir Crit Care Med. 2015;191(8):902-91325
dAlcian blue PAS-farvning af slim i cellerne i luftvejsepitelet.25
eResultater fra et observationsstudie af 1553 patienter med GOLD spirometri grad 2-4 KOL (postbronkodilaterende FEV1/FVC ratio <0,7, med FEV, >80 % anslået)23
fResultater fra et 1-årigt observationsstudie af 479 patienter med KOL, hvoraf 173 havde
eosinofilniveauer i blodet ≥200 celler/μL og/eller ≥2 % af det samlede antal hvide blodlegemer24
KOL, kronisk obstruktiv lungesygdom; EOS, eosinofile celler; FEV1, forceret udåndingsvolumen på 1 sekund;FVC, forceret vitalkapacitet; GOLD, Global Initiative for Chronic Obstructive Lung Disease; IFN-y, interferon-gamma; ILC2, medfødte lymfoide type-2 celler; MUC5AC, mucin 5AC; PAS, periodic acid-Schiff; TNF-a, tumornekrosefaktor alfa; TSLP, tymisk stromal lymfopoietin
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