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Asthma attack severity and urinary concentration of eosinophil X protein in children
Wassim Khalil Kalaajieh1, Rémi Hoilat
1Public Health Faculty - Lebanese University. Najran-Saudi Arabia. wkalajie@ul.edu.lb
Insights
Urinary eosinophil protein X (U-EPX) levels in children with asthma correlate with attack severity. Measuring U-EPX can help quantify bronchial inflammation and monitor disease activity.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Biomarker Discovery
Background:
- Asthma management in children requires objective measures of disease activity and severity.
- Existing methods for assessing asthma exacerbations may not fully capture the underlying inflammatory processes.
- Urinary eosinophil protein X (U-EPX) has emerged as a potential non-invasive biomarker for eosinophilic airway inflammation.
Purpose of the Study:
- To determine if urinary eosinophil protein X (U-EPX) concentrations can objectively predict the severity and activity of asthma in children.
- To investigate the correlation between U-EPX levels and clinical parameters of asthma exacerbations.
- To assess the utility of U-EPX as a marker for bronchial inflammation and disease staging.
Main Methods:
- U-EPX concentrations were measured in 80 non-atopic asthmatic children during attacks and two weeks post-exacerbation.
- A control group of 25 healthy children was included for comparison.
- U-EPX levels were quantified using radioimmunoassay and correlated with asthma severity scores, clinical, radiological findings, blood oxygen saturation, peak expiratory rate, and eosinophil counts.
Main Results:
- Asthmatic children exhibited significantly higher U-EPX concentrations during attacks compared to controls (139.6 vs. 35.3 microg/mmol creatinine).
- U-EPX levels decreased significantly two weeks after exacerbation resolution (66.5 microg/mmol creatinine).
- Severe asthma attacks showed the highest U-EPX concentrations (191.5 microg/mmol creatinine), with persistently elevated levels at follow-up, unlike mild or moderate attacks.
Conclusions:
- Urinary eosinophil protein X (U-EPX) concentrations significantly correlate with asthma attack severity in children.
- U-EPX serves as a valuable tool for quantifying bronchial inflammation and monitoring disease exacerbations.
- This biomarker can aid in early diagnosis, staging of inflammatory disorders, and tracking therapeutic interventions in pediatric asthma.
Objective:
Determination of the urinary concentration of eosinophil protein X (U-EPX) may objectively predict the severity and activity of asthma in children.
Methods:
Concentrations of U-EPX in 80 non- atopic asthmatic children were compared with those in 25 healthy control children. The patients were studied during attacks and two weeks later. The severity of asthma attacks was determined according to a pre-existing score. U-EPX was measured by the specific radioimmunoassay technique (Pharmacia, Uppsala, Sweden). This measurement was correlated with the clinical and radiological investigations as well as with other variables such as blood oxygen saturation, peak expiratory rate and eosinophil count.
Results:
U-EPX concentrations were significantly higher in all asthmatic children during attacks (139.6 11.7 microg/mmol of creatinine) than those in the control group (35.3 6.2 microg/mmol of creatinine) (p < 0.001). Two weeks after resolution of the exacerbation, U-EPX significantly decreased (66.5 9.3 microg/mmol of creatinine) (p < 0.001). U-EPX concentrations were highest in patients with severe attacks (191.5 11.3 microg/mmol of creatinine) (p < 0.001). No statistically significant differences were found between mild (88.2 7.2 microg/mmol of creatinine) and moderate attacks (119.6 8.5 microg/mmol of creatinine). At the two-week follow-up, U-EPX concentrations in patients with mild or moderate attacks was similar to those in controls but were persistently elevated in the subgroup with severe attacks (103.8 9.4 microg/mmol of creatinine) (p < 0.001). No significant correlation was found between U-EPX concentrations and blood oxygen saturation, peak expiratory rate or eosinophil count.
Conclusion:
A statistically significant correlation was found between U-EPX concentrations and the severity of attacks in asthmatic children. This substance could be useful in quantifying bronchial inflammation. This result could further be used as a marker of severity of disease exacerbation and would not only facilitate early diagnosis and staging of inflammatory and allergic disorders but would also allow therapy and interventions to be monitored.