Dr. Ferguson:   No.

Dr. Mannino:   No.

Dr. Casaburi:   Certainly one of the biomarkers that's getting a great deal of attention right now, and something actually that the COPD Foundation is looking at are eosinophil counts as markers of activity, and perhaps of a TH2 response. Although in the press conference for the FLAME Study, it was stated that eosinophil counts accounts did not predict outcomes of therapy, although, at last year's ERS they said it did, although it was a higher threshold. And the debate in eosinophil counts is it 2%, 3%, 4%.

Dr. Ferguson:   Absolute 300.

Dr. Mannino:   Absolute 300. Ian Pavord has some very nice, convincing data, but then some of the data in the poster session today was equally unimpressive, so stay tuned.

Dr. Casaburi:   At this stage it's a clinical trial special. Is it possible that eosinophil levels are helpful? Well, if they're very high, I think that they are helpful, they probably are helpful. When they go down to 2% or 3% range, where a lot of people live, are those helpful, and that answer is not clear yet, I would say.

Dr. Ferguson:   Honestly, all the levels we're talking about are normal. They're all below the threshold of what your lab will say isn’t normal.

Dr. Casaburi:   That's correct, but in that normal range, are they helpful-the answer is not there. High ones in the rare patients may well be helpful in this case.

Dr. Ferguson:   I'm not a huge eosinophil fan right now, but I'm willing to be swayed. There's a gross discrepancy between your bloody eosinophil counts and sputum. In my own personal anecdotal experience, when I see somebody who has a high eosinophilia and they don't have obvious other allergic kind of asthma-type symptomatology, I look elsewhere. Most of the time, they have allergic rhinitis. That doesn't mean you don't treat it, you definitely treat the allergic rhinitis. How often do you measure sputum? Never.

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