Analysis of the use of blood parameters in COPD and ACOS for the purposes of disease differentiation

Zorlu,Duygu

doi:10.3892/wasj.2021.133

Analysis of the use of blood parameters in COPD and ACOS for the purposes of disease differentiation

Authors:
- Duygu Zorlu
View Affiliations

Affiliations: Department of Pulmonology, Faculty of Medicine, Ahi Evran University, Kirsehir 40100, Turkey
Published online on: October 13, 2021 https://doi.org/10.3892/wasj.2021.133
Article Number: 62
Copyright: © Zorlu . This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The definition of asthma‑chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has recently been changed to ‘ACO’ in cases in which certain clinical manifestations of both asthma and COPD are present. In ACO, difficulties in diagnosis and differential diagnosis occur, since inflammation and related pathophysiological changes cannot be clearly demonstrated. In the present study, blood parameters were evaluated with regards to the differential diagnosis of ACO‑COPD and are presented with the aim of providing an approach that is easy to apply in daily practice. The present study was conducted in February, 2020 on patients who presented to the pulmonology department. A total of 50 patients with COPD and 51 patients with ACO who were newly diagnosed were included in the study. The results revealed that there were significant differences between the ACO and COPD groups in terms of their neutrophil and lymphocyte counts, platelet (PLT) and C‑reactive protein (CRP) counts, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) (P<0.05). However, no statistically significant differences were found between the groups in terms of their eosinophil ratio and mean platelet volume (MPV) count (P>0.05). The mean neutrophil count, NLR, PLR and CRP values were significantly higher in the COPD group than the ACO group. In the ACO group, the mean PLT and lymphocyte count values were significantly higher than those in the COPD group. According to the findings of the present study, although role of inflammation in ACO has not been fully clarified, the presence of eosinophilia in ACO does not significantly contribute to the differential diagnosis of COPD. MPV also lacks clinically significant differential properties in COPD and ACO. However, the mean PLT and lymphocyte counts were significantly higher in the ACO than in the COPD group, which maybe a promising result in the differential diagnosis of COPD. Thus, the present study may provide insight into the differential diagnosis between ACO and COPD.

View Figures

View References

1	Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, Menezes AM, Sullivan SD, Lee TA, Weiss KB, et al: BOLD Collaborative Research Group: International variation in the prevalence of COPD (the BOLD Study): A population-based prevalence study. Lancet. 370:741–750. 2007.PubMed/NCBI View Article : Google Scholar
2	Kessler R, Partridge MR, Miravitlles M, Cazzola M, Vogelmeier C, Leynaud D and Ostinelli J: Symptom variability in patients with severe COPD: A pan-European cross-sectional study. Eur Respir J. 37:264–272. 2011.PubMed/NCBI View Article : Google Scholar
3	Montes de Oca M, Perez-Padilla R, Tálamo C, Halbert RJ, Moreno D, Lopez MV, Muiño A, José Roberto BJ, Valdivia G, Pertuzé J, et al: PLATINO Team: Acute bronchodilator responsiveness in subjects with and without airflow obstruction in five Latin American cities: The PLATINO study. Pulm Pharmacol Ther. 23:29–35. 2010.PubMed/NCBI View Article : Google Scholar
4	Global Initiative for Asthma (GINA): Diagnosis of Diseases of Chronic Airflow Limitation: Asthma, COPD and Asthma-COPD Overlap Syndrome (ACOS). GINA, Fontana, WI, 2014. http://www.goldcopd.org.
5	Şen E, Oğuzülgen K, Bavbek S, Günen H, Kıyan E, Türktaş H, Yorgancıoğlu A, Polatlı M, Yıldız F, Çelik G, et al: Asthma-COPD overlap syndrome. Tuberk Toraks. 63:265–277. 2015.PubMed/NCBI View Article : Google Scholar : (In Turkish).
6	Mauad T and Dolhnikoff M: Pathologic similarities and differences between asthma and chronic obstructive pulmonary disease. Curr Opin Pulm Med. 14:31–38. 2008.PubMed/NCBI View Article : Google Scholar
7	Wurst KE, Kelly-Reif K, Bushnell GA, Pascoe S and Barnes N: Understanding asthma-chronic obstructive pulmonary disease overlap syndrome. Respir Med. 110:1–11. 2016.PubMed/NCBI View Article : Google Scholar
8	Inoue H, Nagase T, Morita S, Yoshida A, Jinnai T and Ichinose M: Prevalence and characteristics of asthma-COPD overlap syndrome identified by a stepwise approach. Int J Chron Obstruct Pulmon Dis. 12:1803–1810. 2017.PubMed/NCBI View Article : Google Scholar
9	Bateman ED, Reddel HK, van Zyl-Smit RN and Agusti A: The asthma-COPD overlap syndrome: Towards a revised taxonomy of chronic airways diseases? Lancet Respir Med. 3:719–728. 2015.PubMed/NCBI View Article : Google Scholar
10	Global Initiative for Asthma (GINA): Global Strategy for Asthma Management and Prevention. GINA, Fontana, WI, 2014. https://ginasthma.org/wp-content/uploads/2019/01/2014-GINA.pdf.
11	Zeki AA, Schivo M, Chan A, Albertson TE and Louie S: The asthma-COPD overlap syndrome: A common clinical problem in the elderly. J Allergy (Cairo). 2011(861926)2011.PubMed/NCBI View Article : Google Scholar
12	Gibson PG and Simpson JL: The overlap syndrome of asthma and COPD: What are its features and how important is it? Thorax. 64:728–735. 2009.PubMed/NCBI View Article : Google Scholar
13	Terradas R, Grau S, Blanch J, Riu M, Saballs P, Castells X, Horcajada JP and Knobel H: Eosinophil count and neutrophil-lymphocyte count ratio as prognostic markers in patients with bacteremia: a retrospective cohort study. PLoS One. 7(e42860)2012.PubMed/NCBI View Article : Google Scholar
14	Dirican N, Anar C, Kaya S, Bircan HA, Colar HH and Cakir M: The clinical significance of hematologic parameters in patients with sarcoidosis. Clin Respir J. 10:32–39. 2016.PubMed/NCBI View Article : Google Scholar
15	Akyüz A, Akkoyun DÇ, Oran M, Değirmenci H and Alp R: Mean platelet volume in patients with obstructive sleep apnea and its relationship with simpler heart rate derivatives. Cardiol Res Pract. 2014(454701)2014.PubMed/NCBI View Article : Google Scholar
16	Bülbül Y, Aydın Özgür E and Örem A: Platelet indices in obstructive sleep apnea: The role of mean platelet volume, platelet distribution widht and plateletcrit. Tuberk Toraks. 64:206–210. 2016.PubMed/NCBI View Article : Google Scholar
17	Karadeniz G, Aktoğu S, Erer OF, Kır SB, Doruk S, Demir M and Sonat K: Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease. Biomark Med. 10:701–710. 2016.PubMed/NCBI View Article : Google Scholar
18	Çoban Ağca M, Aksoy E, Duman D, Özmen İ, Yıldırım E, Güngör S, Durmuş N, Aka Aktürk Ü, Saltürk C, Tepetam FM, et al: Does eosinophilia and neutrophil to lymphocyte ratio affect hospital re-admission in cases of COPD exacerbation? Tuberk Toraks. 65:282–290. 2017.PubMed/NCBI View Article : Google Scholar
19	de Marco R, Pesce G, Marcon A, Accordini S, Antonicelli L, Bugiani M, Casali L, Ferrari M, Nicolini G, Panico MG, et al: The coexistence of asthma and Chronic Obstructive Pulmonary Disease (COPD): prevalence and risk factors in young, middle-aged and elderly people from the general population. PLoS One. 8(e62985)2013.PubMed/NCBI View Article : Google Scholar
20	Hardin M, Silverman EK, Barr RG, Hansel NN, Schroeder JD, Make BJ, Crapo JD and Hersh CP: COPDGene Investigators. The clinical features of the overlap between COPD and asthma. Respir Res. 12(127)2011.PubMed/NCBI View Article : Google Scholar
21	Zorlu D, Dirican A, Bayiz H, Uzar T, Topbasi N and Ozkaya S: Asthma, asthma-COPD overlap syndrome and chronic obstructive pulmonary disease in Turkey. Minerva Pneumol. 57:68–72. 2018.
22	Uchida A, Sakaue K and Inoue H: Epidemiology of asthma-chronic obstructive pulmonary disease overlap (ACO). Allergol Int. 67:165–171. 2018.PubMed/NCBI View Article : Google Scholar
23	Soler-Cataluña JJ, Cosío B, Izquierdo JL, López-Campos JL, Marín JM, Agüero R, Baloira A, Carrizo S, Esteban C, Galdiz JB, et al: Consensus document on the overlap phenotype COPD-asthma in COPD. Arch Bronconeumol. 48:331–337. 2012.PubMed/NCBI View Article : Google Scholar
24	Louie S, Zeki AA, Schivo M, Chan AL, Yoneda KY, Avdalovic M, Morrissey BM and Albertson TE: The asthma-chronic obstructive pulmonary disease overlap syndrome: pharmacotherapeutic considerations. Expert Rev Clin Pharmacol. 6:197–219. 2013.PubMed/NCBI View Article : Google Scholar
25	Bujarski S, Parulekar AD, Sharafkhaneh A and Hanania NA: The asthma COPD overlap syndrome (ACOS). Curr Allergy Asthma Rep. 15(509)2015.PubMed/NCBI View Article : Google Scholar
26	Soriano JB, Davis KJ, Coleman B, Visick G, Mannino D and Pride NB: The proportional Venn diagram of obstructive lung disease: Two approximations from the United States and the United Kingdom. Chest. 124:474–481. 2003.PubMed/NCBI View Article : Google Scholar
27	Papaiwannou A, Zarogoulidis P, Porpodis K, Spyratos D, Kioumis I, Pitsiou G, Pataka A, Tsakiridis K, Arikas S, Mpakas A, et al: Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS): Current literature review. J Thorac Dis. 6 (Suppl 1):S146–S151. 2014.PubMed/NCBI View Article : Google Scholar
28	Yoshida M, Nakano T, Fukuyama S, Matsumoto T, Eguchi M, Moriwaki A, Takata S, Machida K, Kanaya A, Matsumoto K, et al: Effects of tiotropium on lung function in severe asthmatics with or without emphysematous changes. Pulm Pharmacol Ther. 26:159–166. 2013.PubMed/NCBI View Article : Google Scholar
29	Song JH, Lee CH, Kim JW, Lee WY, Jung JY, Park JH, Jung KS, Yoo KH, Park YB and Kim DK: Clinical implications of blood eosinophil count in patients with non-asthma-COPD overlap syndrome COPD. Int J Chron Obstruct Pulmon Dis. 12:2455–2464. 2017.PubMed/NCBI View Article : Google Scholar
30	Hikichi M, Hashimoto S and Gon Y: Asthma and COPD overlap pathophysiology of ACO. Allergol Int. 67:179–186. 2018.PubMed/NCBI View Article : Google Scholar
31	Izbicki G, Teo V, Liang J, Russell GM, Holland AE, Zwar NA, Bonevski B, Mahal A, Eustace P, Paul E, et al: Clinical Characteristics Of Patients With Asthma COPD Overlap (ACO) In Australian Primary Care. Int J Chron Obstruct Pulmon Dis. 14:2745–2752. 2019.PubMed/NCBI View Article : Google Scholar
32	Yanagisawa S and Ichinose M: Definition and diagnosis of asthma-COPD overlap (ACO). Allergol Int. 67:172–178. 2018.PubMed/NCBI View Article : Google Scholar
33	Fu JJ, McDonald VM, Gibson PG and Simpson JL: Systemicinflam-mation in older adults with asthma-COPD overlap syndrome. Allergy Asthma Immunol Res. 6:316–324. 2014.PubMed/NCBI View Article : Google Scholar