The effect of eosinophil chemotactic factors on in vitro eosinopoiesis in the guinea pig

Summary The influx of eosinophils to tissue sites is regulated by several well-characterized eosinophil chemotactic factors. In the present investigation the effect of such factors on eosinopoiesis was studied in guinea pig liquid bone marrow cultures. Addition of neutrophil-derived eosinophil chemotactic leukotrienes, synthetic leukotriene B₄, zymosan-activated serum, purified hog C3a, C5a, C5a-des-arg, and synthetic N-formyl-methionyl-phenylalanine did not increase eosinophil numbers in marrow cultures, while supernatants of spleen or lymph node cells stimulated by concanavalin A were highly effective. ³H-thymidine labelling of cultured eosinophils was not increased by any of the added mediators. A quantitative correlation between eosinopoietic and eosinotactic activity could not be established. These in vitro data suggest therefore that eosinopoiesis and migration of guinea pig eosinophils to tissue sites are regulated by separate chemical mediators.Supported by a grant (Cz 22/4-3) from the Deutsche Forschungsgemeinschaft     

Eosinopenia: Is it a good marker of sepsis in comparison to procalcitonin and C-reactive protein levels for patients admitted to a critical care unit in an urban hospital?

IntroductionThe role of eosinopenia as a marker of sepsis has recently been evaluated. The aim of our study was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to procalcitonin and C-reactive protein levels.MethodsA prospective study of critically ill adult patients admitted to the medical intensive care unit at an urban hospital. Procalcitonin, C-reactive protein (CRP) levels and eosinophil counts were measured on admission. Patients were classified as non-infected or infected by the medical residents, fellows, and attendings.ResultsA total of 68 patients were enrolled into the study. At a cut-off value of 70 mg/L, the CRP level yielded a sensitivity of 94%, a specificity of 84%, a positive predicted value (PPV) of 83% and a negative predicted value (NPV) of 94%. At a cutoff value of 1.5 μg/L, the sensitivity of the procalcitonin test was 84%, specificity of 92%, PPV 90%, and NPV of 87%. The eosinophil cell count (cutoff of 50 cells/mm³) produced a sensitivity of 81%, specificity of 65%, a PPV of 66%, and a NPV of 80%.The comparison of the eosinophil cell count (<50 cells/mm³) and procalcitonin levels among the non-infected and infected groups showed a significant statistical difference (Fisher exact test, P = .0239). There was no statistical difference observed when comparisons were made between CRP levels and eosinophil count (Fisher exact test, P = .12). There was also a lack of significant statistical difference when CRP levels were compared to procalcitonin levels (Fisher exact test, P = .49).ConclusionEosinopenia is a very sensitive yet not specific serological marker of sepsis in the intensive care unit and can be utilized to guide physicians in the diagnosis of sepsis.     

Haematological findings in cats naturally infected with feline immunodeficiency virus

The types and prevalence of haematological abnormalities occurring in FIV infected cats were determined. In addition, the role of FIV infection per se in influencing haematological values was examined by analysing results between infected and non-infected cats which had been allocated to similar clinical disease groups. FIV-positive cats were grouped as asymptomatic carriers (AC), cats with AIDS-related complex (ARC) or AIDS. FIV-negative cats were placed into matched groups using the same criteria and designated as healthy, ARC or AIDS. Healthy FIV-negative cats also formed the reference ranges for peripheral blood and bone marrow. Anaemia was no more frequent in sick (ARC and AIDS) FIV-positive cats than sick (ARC and AIDS) FIV-negative cats. However, it was observed more frequently in FIV-positive cats than FIV-negative cats in the absence of concurrent disease, suggesting a direct effect of FIV infection. Bone marrow was affected by FIV infection; as evidenced by anaemic FIV-positive cats having proportionally less Type I reticulocytes than anaemic FIV-negative cats. In addition, FIV-positive cats demonstrated proportionally fewer mature erythroid cells in their marrow. This implied that FIV may cause a decreased life span or maturation arrest of the erythroid cell line. Lymphopenia and eosinopenia were seen more frequently in AC FIV-positive cats than healthy FIV-negative cats, suggesting the direct involvement of FIV. Thus, although FIV infection affected some haematological findings in AC cats, it appeared that haematological abnormalities in sick FIV-positive cats may be due as much to the disease state as to the virus specifically. Apart from the subjective assessment that bone marrow of FIV-positive cats appeared hypercellular, there were no pathognomonic features for FIV infection.     

Eosinopenia <100/μL as a marker of active COVID-19: An observational prospective study

ObjectivesTo analyse the diagnostic performance of eosinopenia, alone or combined with polymorphonuclear neutrophils (PMN) and/or lymphocytes, as a marker of active COVID-19 in patients hospitalized for suspicion of SARS-CoV-2 infection.MethodsA prospective observational study including patients hospitalized for suspicion of COVID-19 in a COVID unit was performed from 20th March to 5th April 2020, in Perpignan, France. Patients for which there was a doubt upon diagnosis, who were recently under oral corticosteroids, had myeloid malignancy or human immunodeficient virus infection were excluded. SARS-CoV-2 detection was performed using an RT-PCR assay, from nasopharyngeal swab specimens. Complete blood count were performed for all patients.ResultsOne-hundred and twenty-one patient were included: 57 patients were diagnosed with COVID-19, 64 patients were not. Eosinophil count was lower in the COVID-19 group (median: 0/μL versus 70/μL, p < 0.0001). To diagnose COVID-19, eosinopenia had a sensitivity of 89.5% and a specificity of 78.1% while lymphopenia's were 73.7% and 62.5% respectively. Using area under curve (AUC) of receiving operating characteristics (ROC) curves, eosinophil's optimal cut-off level was 10/μL, sensitivity and specificity were 86%, and 79.7% respectively. Regarding the eosinophil/PMN ratio, the optimal cut-off level was 3.344, sensitivity and specificity were 87.7% and 73.4% respectively. The AUC of lymphocyte/PMN ratio was significantly lower than eosinophil/PMN ratio's (0.621 versus 0.846, p = 0.0003).ConclusionEosinopenia – <10/μL – and eosinophil/PMN ratio are useful, low-cost, reproducible tools to help diagnose COVID-19, during an epidemic period, in a population of hospitalized patients admitted for suspicion of COVID-19.     

Eosinopenia and post-hospital outcomes in critically ill non-cardiac vascular surgery patients

Background and aimsEosinopenia is a marker for acute inflammation. We hypothesized that eosinopenia at Intensive Care Unit (ICU) admission in vascular surgery patients who receive critical care, would be associated with increased mortality following hospital discharge.Methods and resultsWe performed a two-center observational cohort study of critically ill, non-cardiac adult vascular surgery patients who received treatment in Boston between 1997 and 2012 and survived hospital admission. The consecutive sample included 5083 patients (male 57%, white 82%, mean age [SD] 61.6 [17.4] years). The exposure was Absolute eosinophil count measured within 24 h of admission to the ICU and categorized as ≤10 cells/μL, 11–50 cells/μL, 51–100 cells/μL, 101–350 cells/μL (normal range), and >350 cells/μL.The primary outcome was all-cause mortality within 90 days of hospital discharge. The secondary outcome was discharge to home following hospitalization. 90-day post-discharge mortality was 6.7%, and 12.9% of patients were readmitted within 30 days. After multivariable adjustment, patients with eosinopenia (≤10 cells/μL) have a 90-day post-discharge mortality OR of 1.97 (95%CI 1.42, 2.73; P < 0.001) relative to patients with an absolute eosinophil count of 101–350 cells/μL. Further, after multivariable adjustment, patients with eosinopenia (≤10 cells/μL) have a 25% lower odds of discharge to home compared to patients with an absolute eosinophil count of 101–350 cells/μL [OR = 0.71 (CI 95% 0.59–0.85); P < 0.001].ConclusionEosinopenia at ICU admission is a robust predictor of increased mortality and lower likelihood of discharge to home in vascular surgery patients treated with critical care who survive hospitalization.     

Eosinopenia as an Adverse Marker of Clinical Outcomes in Patients Presenting with Acute Myocardial Infarction

BackgroundEosinopenia is considered a surrogate of inflammation in several disease settings. Following ST-segment elevation myocardial infarction, eosinopenia is presumed to be a marker of infarct severity. We sought to study the relationship between eosinopenia and infarct severity and how this relationship determined the long-term outcomes following ST-segment elevation myocardial infarction.MethodsSix hundred and six consecutive patients undergoing primary percutaneous coronary interventions from a large volume single center were enrolled. Low eosinophil count was defined as < 40 cells/mL from samples within 2 hours after reperfusion. Primary endpoint was defined as composite of death, myocardial infarction, stroke, unplanned revascularization, and readmission for heart failure over 3.5 years’ follow-up.ResultsSixty-five percent of the patients had eosinopenia. Patients in the low eosinophil group had larger infarct size as measured by troponin value (2934 vs 1177 ng/L, P < .001) and left ventricle systolic function on echocardiography (48% vs 50%, P = 0.029). There was a weak correlation between eosinophil count and both troponin (r = -0.25, P < 0.001) and ejection fraction (r = 0.10, P = .017). The primary endpoint was higher in eosinopenic patients (28.8% vs. 20.4%; hazard ratio [HR] 1.49, 95% confidence interval [CI] 1.05 to 2.13, P = .023). A discordance between eosinopenia and severe left ventricle systolic dysfunction was observed in 55.6% of cases. Compared with normal count, eosinopenia was associated with worse clinical outcomes in patients with non-severe left ventricle dysfunction (24.1% vs 16.2%; HR 1.58, 95% CI 1.01 to 2.45, P = .044) but not in those with severe left ventricle dysfunction (42.3% vs. 38.9%; HR 1.10, 95% CI 0.59 to 2.03, P = .77) (P < .01 for interaction).ConclusionsEosinopenia is an easily determined marker that reflects worse clinical outcomes over long-term follow-up.     

Proposition d’un score prédictif d’infection bactérienne selon le taux d’éosinophiles : étude observationnelle

Introduction

Several studies have shown that eosinopenia less than 0.04 g/L is a marker of bacterial infection in the presence of unexplained inflammatory syndrome. The aim of our study was to test this hypothesis and to propose a predictive score for bacterial infection (score CIBLE, C reactive protein, bacterial infections, levels of leucocytes and eosinophils).

L’éosinopénie en 2018

Since 1893, eosinopenia is a biological test to help a diagnosis of bacterial infection. Several publications have confirmed this hypothesis, particularly in the intensive care, pneumology and pediatric units. The value of this marker has been identified in vascular cerebral diseases and coronary bypass. Its contribution seems as relevant as procalcitonin, without extra cost. The diagnostic performance of this test was reinforced by a composite score (CIBLE score) that may improve its value in daily routine. Finally, monitoring eosinopenia appears to be a reliable mortality marker.