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Clinical value of monitoring eosinophil activity in asthma
1Division of Allergy, University Children's Hospital, Vienna, Austria.
Insights
Serum eosinophil cationic protein (ECP) levels are elevated in children with asthma and correlate with disease severity. Monitoring ECP can help track inflammation and optimize treatment for pediatric asthma.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Biomarker Research
Background:
- Childhood asthma is a significant respiratory condition.
- Accurate monitoring of disease activity is crucial for effective management.
- Eosinophils play a role in asthma pathogenesis.
Purpose of the Study:
- To evaluate serum eosinophil cationic protein (ECP) as a marker for monitoring childhood asthma activity.
- To assess the relationship between ECP levels and asthma severity.
- To investigate the influence of atopy and infection on ECP levels in asthmatic children.
Main Methods:
- Serum ECP concentrations were measured in 175 children with asthma.
- Control groups included children with cystic fibrosis, lower respiratory tract infections (LRTI), and healthy children.
- A longitudinal trial assessed ECP changes during anti-asthmatic treatment.
Main Results:
- Serum ECP levels were significantly higher in asthmatic children compared to healthy controls.
- Symptomatic asthmatic patients showed increased ECP compared to asymptomatic patients.
- Atopy and infection were associated with enhanced eosinophil activity, as indicated by higher ECP levels.
- Anti-asthmatic treatment, particularly steroids, reduced serum ECP levels within four weeks.
Conclusions:
- Eosinophils are central to childhood asthma.
- Serum ECP concentrations correlate with asthma severity and can monitor inflammation.
- Atopy and infection enhance eosinophil activity in pediatric asthma.
- Longitudinal ECP measurements aid in optimizing anti-inflammatory treatment for childhood asthma.
Abstract:
To evaluate the use of eosinophil cationic protein (ECP) in monitoring disease activity in childhood asthma, serum ECP in 175 asthmatic children was assessed. Forty five patients with cystic fibrosis, 23 with lower respiratory tract infections (LRTI), and 87 healthy children were used as controls. Serum ECP concentrations (34.3 micrograms/l v 9.8 micrograms/l) were significantly higher in children with bronchial asthma than in healthy control subjects. In symptomatic patients with asthma serum ECP concentrations were increased compared with those from asymptomatic patients (40.2 micrograms/l v 14.4 micrograms/l), irrespective of treatment modalities (that is steroids, beta 2 agonists, or sodium cromoglycate). Moreover, atopy and infection appeared to be factors enhancing eosinophil activity in bronchial asthma as measured by serum ECP (58.4 micrograms/l v 36.8 micrograms/l and 68.8 micrograms/l v 42.2 micrograms/l, respectively). In a longitudinal trial, antiasthmatic treatment modalities (that is steroids) reduced serum ECP within four weeks (42.2 micrograms/l v 19.0 micrograms/l). In conclusion, the data indicate that (1) eosinophils also play a central part in childhood asthma; (2) serum concentrations of ECP in children with bronchial asthma are related to the disease severity and may thus be used for monitoring inflammation in childhood asthma; (3) eosinophil activity appears to be enhanced by atopy and infection; and (4) longitudinal measurements of serum ECP concentrations may be useful for optimising anti-inflammatory treatment in children with bronchial asthma.