Young smokers with higher blood eosinophil counts show elevated type 2 biomarkers in the BEACON study

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Blood eosinophil counts (BEC) are elevated in a subgroup of COPD patients. Smoking is associated with higher BEC in the general population. We investigated characteristics of young smokers, at risk of developing COPD, with higher BEC. BEC were obtained from smokers (S) aged 30-45 years enrolled onto the British EArly COPD Network (BEACON) study ( NCT03480347 ) and compared to data from age matched healthy non-smokers (HNS). BEACON participants had normal spirometry and ≥10 pack years. Low, intermediate and high BEC were defined by thresholds of ≤100 (BEClo), 100-300 (BECint) and ≥300 (BEChi) cells/µL respectively. 103 HNS and 499 S were included; Median BEC were 120 and 180cells/µL, respectively (p<0.01, fig 1). For S, BEClo, BECint and BEChi comprised 37.9, 41.3 and 20.8% of the population, respectively. Compared to BEClo, BEChi were more likely to be male (45.6 vs 76.0% male, p<0.01) and have higher BMI (25.1 vs 26.4kg/m2, p=0.03). BEChi had higher FeNO50 compared to BEClo and BECint (22.7 vs 15.0 and 11.9ppb, p=0.03 and <0.01, respectively) and higher blood basophil counts (0.10 vs 0.03 and 0.05, respectively, p<0.01 for both). No differences in CAT score or presence of chronic bronchitis were observed. We demonstrate that BEC are higher in S versus age-matched HNS. Elevated BEC in S are associated with being male, higher BMI and elevated markers of type 2 inflammation. erj;66/suppl_69/PA1503/F1 F1 F1 Fig 1: BEC for HNS versus S.

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