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Eosinophil cationic protein in serum and nasal washes from wheezing infants and children
J M Ingram1, G P Rakes, G E Hoover
1Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Insights
Eosinophil cationic protein (ECP) levels in nasal washes were significantly higher in wheezing children, especially those under two years old, suggesting eosinophils play a role in early childhood airway inflammation.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Cellular Biology
Background:
- Wheezing in infants and children is a common clinical presentation.
- The role of eosinophils in pediatric airway inflammation is not fully understood.
- Eosinophil cationic protein (ECP) is a marker of eosinophil activation.
Purpose of the Study:
- To compare eosinophil cationic protein (ECP) concentrations and eosinophil counts in serum and nasal wash fluid.
- To differentiate between wheezing children and healthy controls.
- To investigate the association between ECP levels and other markers of eosinophilic inflammation.
Main Methods:
- A case-control study involving 71 wheezing children and 59 controls aged 2 months to 16 years.
- Measurement of ECP concentrations and eosinophil counts in serum and nasal washes.
- Assessment of total serum IgE and IgE antibodies to common aeroallergens using radioallergosorbent test (RAST).
Main Results:
- Elevated nasal ECP levels (> 200 ng/ml) were found in 41% of wheezing infants (< 2 years) versus 6% of controls (p < 0.03).
- In children over 2 years, significantly higher nasal ECP levels were observed in wheezing patients (p < 0.001).
- Positive correlations were noted between nasal ECP and blood eosinophil counts, serum ECP, and nasal eosinophil counts in older children.
Conclusions:
- Increased ECP concentrations in nasal washes indicate eosinophil involvement in wheezing infants and children.
- Eosinophils may contribute to airway inflammation in early-onset wheezing.
- ECP serves as a valuable biomarker for eosinophilic airway inflammation in pediatric wheezing.
Objective:
To compare eosinophil counts and concentrations of eosinophil cationic protein (ECP) in serum and nasal wash fluid from wheezing infants and children with those from age-matched children without respiratory tract symptoms.
Design:
A case-control study of 71 children treated for wheezing and 59 control subjects in the University of Virginia Pediatric Emergency Department. The patients ranged from 2 months to 16 years of age. Eosinophil numbers and ECP concentrations were assessed in serum and nasal washes. Total serum IgE was measured and the radioallergosorbent test was used to measure IgE antibody to common inhalant allergens.
Results:
Among children less than the age of 2 years, markedly elevated levels of ECP (> 200 ng/ml) were measured in nasal washes from 9 (41%) of 22 wheezing patients and 1 (6%) of 17 control subjects (p < 0.03). None of these children had a positive radioallergosorbent test result for IgE antibody to common aeroallergens or a nasal smear containing 10% eosinophils. Few of the wheezing children under 2 years of age had either increased concentrations of total IgE or ECP in their serum or an elevated total blood eosinophil count. After the age of 2 years, the percentage of patients with nasal ECP levels greater than 200 ng/ml was also significantly higher in wheezing children than in control subjects (p < 0.001), and a positive correlation was observed between ECP concentrations in their nasal washes and other eosinophil responses (total blood eosinophil counts, serum ECP levels, and nasal eosinophil counts).
Conclusion:
Increased concentrations of ECP were detected in nasal washes from wheezing infants and children, indicating that eosinophils may contribute to the pathogenesis of airway inflammation in some children who wheeze early in life.