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Eosinophil cationic protein as a diagnostic marker for asthmatic children treated by immunotherapy
Al-Asfar Kandil1, Ahmad Hasan, Osama Taha
1Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt.
Insights
Eosinophil cationic protein (ECP) in blood and sputum indicates bronchial asthma severity in children. Immunotherapy combined with standard treatment significantly reduced ECP levels and improved symptoms.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Biomarker Research
Background:
- Bronchial asthma in children is linked to eosinophilic inflammation.
- Eosinophil cationic protein (ECP) is a key mediator released during eosinophil degranulation.
- Accurate markers for disease activity and treatment efficacy are needed.
Purpose of the Study:
- To assess eosinophil cationic protein (ECP) levels in serum and sputum of children with bronchial asthma.
- To determine the correlation between ECP levels and asthma severity.
- To evaluate the impact of immunotherapy as an adjunct to pharmacotherapy on ECP levels and clinical outcomes.
Main Methods:
- Serum and sputum ECP levels were measured in 20 children with asthma and 10 healthy controls.
- Asthma patients were categorized by severity (mild/moderate) and treated with either pharmacotherapy alone or pharmacotherapy plus immunotherapy for one year.
- Clinical assessments included history, physical examination, skin prick tests, chest X-rays, complete blood counts, and sputum eosinophil counts.
Main Results:
- Asthmatic children exhibited significantly higher blood and sputum ECP levels compared to controls.
- Moderate asthma cases showed higher ECP levels than mild cases.
- Both treatment groups demonstrated significant reductions in ECP and eosinophil counts post-therapy, with greater improvement in the immunotherapy group.
- Clinical symptoms and medication scores also significantly decreased in both groups after one year.
Conclusions:
- ECP serves as a reliable biomarker for eosinophilic activity and degranulation, correlating with bronchial asthma severity in children.
- Immunotherapy shows promise as an effective adjuvant therapy for childhood atopic bronchial asthma, enhancing treatment outcomes.
Abstract:
We estimated the eosinophil cationic protein (ECP) levels in serum and sputum of 20 children with bronchial asthma to find whether it correlates with disease activity and examine the effect of immunotherapy. Ten-age- and sex- matched healthy children were also included. Children were subjected to full history, clinical examination and investigation including skin prick test, chest x-ray, complete blood count, and estimation of eosinophil cationic protein. In addition, examination of sputum to determine the eosinophil count and eosinophil cationic protein level was carried out. Patients were classified into 2 groups (10 patients each) according to the line of treatment used (5 mild and 5 moderate in severity). Group I received pharmacotherapy only and was followed for one year, while group II, received pharmacotherapy plus immunotherapy for one year. A significant increase in eosinophil count and ECP of blood and sputum was found in asthmatic patients as compared to controls. The ECP levels were significantly higher in moderate cases when compared with mild cases. On comparing levels of both eosinophil count and ECP in peripheral blood and sputum, before and one year after treatment, there was a significant reduction after therapy among the two groups of patients. The reduction was significant in group II. On the other hand there was a significant decrease in both symptoms and medication scores after one year of therapy. In conclusion, ECP may be a marker of eosinophilic activity and degranulation that correlates with the severity of bronchial asthma. Immunotherapy may be a good adjuvant therapy for atopic bronchial asthma of childhood.
