The Relationship between Eosinophilic Activation and Mucus Plug Formation in COPD

This study investigated the link between eosinophilic airway activation and mucus plug formation in COPD. In patients from the London COPD Exacerbation Cohort, higher sputum eosinophil peroxidase levels and blood eosinophil counts were both associated with a greater number of CT-detected mucus plugs. Importantly, blood eosinophils were significantly related to mucus plug burden only in patients with high sputum EPX, and those with concomitantly high blood eosinophils and high sputum EPX had the highest mucus plug scores. These findings indicate that eosinophilic airway activation contributes to mucus plugging in COPD and support the existence of biologically defined subgroups that may benefit from targeted anti-eosinophilic therapies.