Associations of Monocyte Count and Other Immune Cell Types with Interstitial Lung Abnormalities

John S. Kim, Gísli Thor Axelsson, Matthew Moll, Michaela R. Anderson, Elana J. Bernstein, Rachel K. Putman, Tomoyuki Hida, Hiroto Hatabu, Eric A. Hoffman, Ganesh Raghu, Steven M. Kawut, Margaret F. Doyle, Russell Tracy, Lenore J. Launer, Ani Manichaikul, Stephen S. Rich, David J. Lederer, Vilmundur Gudnason, Brian D. Hobbs, Michael H. ChoGary M. Hunninghake, Christine Kim Garcia, Gunnar Gudmundsson, R. Graham Barr, Anna J. Podolanczuk

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Rationale: Higher blood monocyte counts are associated with worse survival in adults with clinically diagnosed pulmonary fibrosis. Their association with the development and progression of interstitial lung abnormalities (ILA) in humans is unknown. Objectives: We evaluated the associations of blood monocyte count, and other immune cell types, with ILA, high-attenuation areas, and FVC in four independent cohorts. Methods: We included participants with measured monocyte counts and computed tomographic (CT) imaging enrolled in MESA (Multi-Ethnic Study of Atherosclerosis, n = 484), AGES-Reykjavik (Age/Gene Environment Susceptibility Study, n = 3,547), COPDGene (Genetic Epidemiology of COPD, n = 2,719), and the ECLIPSE (Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points, n = 646). Measurements and Main Results: After adjustment for covariates, a 1-SD increment in blood monocyte count was associated with ILA in MESA (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.0-1.8), AGES-Reykjavik (OR, 1.2; 95% CI, 1.1-1.3), COPDGene (OR, 1.3; 95% CI, 1.2-1.4), and ECLIPSE (OR, 1.2; 95% CI, 1.0-1.4). A higher monocyte count was associated with ILA progression over 5 years in AGESReykjavik (OR, 1.2; 95% CI, 1.0-1.3). Compared with participants without ILA, there was a higher percentage of activated monocytes among those with ILA in MESA. Higher monocyte count was associated with greater high-attenuation areas in MESA and lower FVC in MESA and COPDGene. Associations of other immune cell types were less consistent. Conclusions: Higher blood monocyte counts were associated with the presence and progression of interstitial lung abnormalities and lower FVC.

Original languageEnglish
Pages (from-to)795-805
Number of pages11
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number7
Publication statusPublished - Apr 1 2022

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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