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Eosinophil cationic protein and tidal flow volume loops in children 0-2 years of age
K C Lødrup Carlsen1, R Halvorsen, S Ahlstedt
1Paediatric Dept, Ullevål Hospital, Oslo, Norway.
Insights
Tidal flow volume (TFV) response and serum eosinophil cationic protein (s-ECP) levels can help differentiate wheezy infants and toddlers. These markers may serve as valuable prognostic tools for early childhood asthma.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Biomarkers in Respiratory Disease
Background:
- Recurrent wheezing in early childhood often precedes asthma development.
- Objective parameters for classifying wheezy infants are limited.
- Tidal flow volume (TFV) response to salbutamol and serum eosinophil cationic protein (s-ECP) show potential for differentiation.
Purpose of the Study:
- To investigate if lung function parameters and s-ECP can differentiate between groups of wheezy young children.
- To explore the relationship between airway inflammation markers and lung function in infants and toddlers.
Main Methods:
- Measured TFV loops in 79 children (mean age 14 months), categorizing them into cases (recurrent wheeze) and controls.
- Assessed airway responsiveness via tPEF/tE changes after salbutamol in a subset of children.
- Measured serum eosinophil cationic protein (s-ECP) and serum myeloperoxidase (s-MPO) in all participants.
Main Results:
- Wheezy children (cases) exhibited significantly lower mean tPEF/tE and higher mean s-ECP compared to controls.
- Serum ECP correlated significantly with airway responsiveness (change in tPEF/tE) but not initial lung function.
- Serum ECP levels were associated with IgE, eosinophil counts, and airway responsiveness, decreasing with age.
Conclusions:
- TFV responsiveness to salbutamol and s-ECP levels are strongly correlated in young children.
- Both TFV responsiveness and s-ECP likely reflect airway inflammation.
- These parameters may serve as valuable prognostic tools for identifying infants and toddlers at risk for persistent wheeze and asthma.
Abstract:
Many children with recurrent wheezing in early childhood develop asthma. Objective parameters to describe different groups of wheezers are limited, but tidal flow volume (TFV) response to inhaled salbutamol has demonstrated differences between children with and without asthma. Also, eosinophil cationic protein (ECP) has been associated with declining lung function in older children. We therefore investigated whether lung function and serum ECP (s-ECP) could differentiate between groups of wheezy young children. TFV loops were measured in 79 awake children (mean age 14 months). Minimum two wheezy episodes (mean 3.2) or minimum 4 weeks persistent wheeze were reported in 41 children (cases), whereas the 38 controls had no history of wheeze. Airways responsiveness (change in ratio of time until peak expiratory flow to total expiratory time (tPEF/tE) after inhaled nebulized salbutamol) was measured in 26 cases and 24 controls. Serum ECP and serum myeloperoxidase (s-MPO) were measured in all children. Cases had significantly lower mean tPEF/tE (0.21) than controls (0.33), and higher mean s-ECP (21.9 micrograms.L-1) than controls (14.0 micrograms.L-1). Serum ECP (but not s-MPO) correlated significantly with the percentage change in tPEF/tE from baseline (r = 0.7), but not with initial tPEF/tE. Serum ECP increased significantly with increasing immunoglobulin E (IgE), airways responsiveness and eosinophil count, but decreased with increasing age. TFV responsiveness to salbutamol and s-ECP levels correlate strongly, both probably reflecting airways inflammation, and may possibly be valuable prognostic tools in recurrent wheezy infants and toddlers.