Blood Eosinophil Reference Values and Determinants in a Representative Adult Population
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Background
The use of blood eosinophil count (BEC) as a prognostic biomarker in the management of conditions such as asthma and chronic obstructive pulmonary disease (COPD) may be complicated by factors like atopy, age, sex, smoking, and comorbidities. Therefore, we aimed to produce reference values for BEC, considering age, asthma, COPD, and clinical allergy for the general adult population.
Methods
The West Sweden Asthma Study constitutes a population-representative clinical epidemiological cohort of randomly selected adults in western Sweden. From this cohort, n =1,145 took part in clinical examinations, including e.g. skin prick testing, specific immunoglobulin E, and BEC.
Results
The upper limit (95 th percentile) of BEC varied by age. It ranged between 400 to 500 cells/μL in the full sample, and from 300 to 400 cells/μL in subjects without asthma, COPD, and clinical allergy ( n =710). Sex, smoking, atopy, clinical allergy, obesity, asthma, COPD, diabetes, and hypertension were statistically significantly associated with higher BEC levels. However, only asthma and clinical allergy in the full sample, and obesity and diabetes in those without asthma, COPD, or clinical allergy, remained statistically significant in multiple regression analyses.
Conclusion
In a population-representative sample, the upper limit of BEC in healthy adults ranged between 300 and 400 cells/μL, varying by age. Age, smoking, obesity, asthma, COPD, and clinical allergy influence BEC levels and should be considered in clinical interpretation.
Clinical Implications
The upper limit of normal blood eosinophil count (BEC) in participants free from asthma, COPD, and clinical allergy ranged between 300 and 400 cells/μL depending on age. These results facilitate the interpretation of BEC in clinical practice.
Capsule summary
The upper limit of normal blood eosinophil count (BEC) in healthy individuals ranged between 300 and 400 cells/μL depending on age. Determinants of BEC values include age, smoking, obesity, asthma, and clinical allergy.
Support statement
The study was supported by the VBG Group Herman Krefting Foundation for Asthma and Allergy Research (Trollhättan, Sweden), Swedish Research Council (Stockholm, Sweden), the Swedish Heart-Lung Foundation (Stockholm, Sweden), the Swedish Asthma and Allergy Foundation (Stockholm, Sweden), Tampere Tuberculosis Foundation (Tampere, Finland), and ALF agreement (grant from the Swedish state under the agreement between the Swedish Government and the county councils, Sweden).
