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Serum eosinophil cationic protein and interleukin-5 in children with bronchial asthma and acute bronchiolitis
K Oymar1, S Elsayed, R Bjerknes
1Department of Pediatrics, Rogaland County Hospital, Stavanger, Norway.
Insights
Serum eosinophil cationic protein (ECP) and interleukin-5 (IL-5) increase during acute asthma and RSV bronchiolitis but cannot reliably distinguish disease severity or type in young children.
Area of Science:
- Pediatric Pulmonology
- Immunology
- Clinical Biomarkers
Background:
- Childhood asthma and bronchiolitis are common respiratory conditions in young children.
- Eosinophil cationic protein (ECP), interleukin-5 (IL-5), and total eosinophil counts are markers of eosinophilic inflammation.
- Understanding the role of these markers in differentiating pediatric respiratory diseases is crucial for accurate diagnosis and management.
Purpose of the Study:
- To evaluate the clinical applicability of serum ECP, IL-5, and total eosinophil counts in childhood asthma and bronchiolitis.
- To assess if these markers can differentiate between symptomatic and asymptomatic asthma phases.
- To investigate differences in these markers between respiratory syncytial virus (RSV) bronchiolitis and other viral infections.
Main Methods:
- Serum ECP, IL-5, and total eosinophil counts were measured in 44 children (12-84 months) with mild to moderate asthma.
- Measurements were taken during symptomatic and asymptomatic phases, including acute asthmatic attacks and after discharge.
- The same parameters were analyzed in 25 infants (1-17 months) with their first episode of acute bronchiolitis.
Main Results:
- Serum ECP was significantly elevated in acute asthma compared to stable asthma or controls, but overlap was large.
- Circulating IL-5 was detected in acute asthma, particularly in atopic children, but not in stable asthma or controls.
- In acute bronchiolitis, serum ECP was higher in RSV-positive cases, while total eosinophil counts decreased; IL-5 was rarely detected.
Conclusions:
- Serum ECP and IL-5 increase during acute asthmatic exacerbations but are insufficient alone to distinguish asthma severity or control in young children.
- The inflammatory profile in RSV bronchiolitis appears distinct from other viral infections, with elevated ECP and decreased eosinophils.
- Further research is needed to identify reliable biomarkers for differentiating pediatric respiratory conditions.
Abstract:
The aim of our study was to evaluate the clinical applicability of serum eosinophil cationic protein (ECP), interleukin-5 (IL-5) and total eosinophil counts in childhood asthma and bronchiolitis. These parameters were measured in 44 children aged 12-84 months with moderate and mild asthma during symptomatic and asymptomatic phases of disease. Fifteen of the patients were included at the time of admission to hospital due to an acute asthmatic attack, and ten of these were also examined one month after discharge. None of the patients were treated with glucocorticoids or cromoglycate at any time during the study. Serum ECP was significantly increased in the children with acute asthma compared to children with stable moderate asthma, stable mild asthma, as well as to controls. There was no difference between the groups with stable asthma or between stable asthma and controls, and there was large overlap between all groups of asthmatics and controls. Detectable levels of circulating IL-5 were demonstrated in eight of 15 children with acute asthma, with significantly higher levels in atopic children, whereas all samples from children with stable asthma and controls were negative. The results suggest that even though serum ECP and IL-5 increases during acute asthmatic attacks, these parameters cannot alone be used to discriminate between different groups of young children with stable asthma, nor between asthmatics and healthy controls. In addition, the same parameters of eosinophil inflammation were examined in serum samples from 25 children aged 1-17 months undergoing their first episode of acute bronchiolitis. Children with acute respiratory syncytial virus (RSV) bronchiolitis had significantly higher levels of serum ECP than those with RSV negative disease, whereas the total eosinophil counts were significantly decreased in all patients with acute bronchiolitis. Serum IL-5 was only detected in two children with acute bronchiolitis. The results suggest that the inflammation in RSV bronchiolitis differs from that induced by other viruses.