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Urinary eosinophil protein X in relation to disease activity in childhood asthma
E Lugosi1, G Halmerbauer, T Frischer
1Division of Allergy and Pulmonology, University Children's Hospital, Vienna, Austria.
Insights
Urinary eosinophil protein X (U-EPX) effectively monitors childhood asthma inflammation. U-EPX levels correlate with disease activity and lung function, aiding in asthma management.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Biomarker Discovery
Background:
- Childhood asthma involves significant airway inflammation.
- Monitoring asthma activity and inflammation is crucial for effective management.
- Current monitoring methods may have limitations in assessing eosinophilic inflammation.
Purpose of the Study:
- To investigate the clinical utility of urinary eosinophil protein X (U-EPX) for monitoring inflammation in childhood asthma.
- To assess the relationship between U-EPX levels, pulmonary function, and disease activity.
- To determine if U-EPX levels are influenced by atopy or asthma treatment modalities.
Main Methods:
- Cross-sectional and longitudinal study involving 80 children with asthma and 24 healthy controls.
- Measurement of U-EPX levels in urine.
- Assessment of pulmonary function tests.
- Follow-up assessments in a subset of patients (n=14) over 1-2 months.
Main Results:
- U-EPX levels were significantly higher in children with asthma compared to controls (P < 0.0001).
- Symptomatic asthmatic patients exhibited higher U-EPX levels than asymptomatic patients (P < 0.0001).
- U-EPX levels showed significant correlations with pulmonary function and changes in pulmonary function over time.
Conclusions:
- Eosinophil activation can be reliably measured in urine using U-EPX in childhood asthma.
- U-EPX concentrations reflect asthma disease activity and are linked to pulmonary function.
- U-EPX measurement shows promise as a valuable tool for assessing inflammation and guiding the management of childhood asthma, independent of atopy and treatment.
Abstract:
The clinical use of urinary eosinophil protein X (U-EPX) measurements in monitoring inflammation in childhood asthma was investigated. U-EPX and pulmonary function were assessed in 80 children with bronchial asthma and 24 healthy, age-matched controls. In addition, 14 patients with asthma were re-examined after 1-2 months. U-EPX levels were increased in children with asthma compared with controls (median 68.4 vs 35.3 micrograms/mmol creatinine; P < 0.0001). In addition, U-EPX levels were higher in symptomatic than in asymptomatic patients (median 123.5 vs 48.9 micrograms/mmol creatinine; P < 0.0001) independent of treatment modalities (i.e., inhaled steroids or disodium cromoglycate) or atopy (median 65.1 vs 86.0 micrograms/mmol creatinine). Furthermore, U-EPX levels were significantly correlated with pulmonary function. During the follow-up period, changes in U-EPX values were significantly related to changes in pulmonary function. In conclusion, our findings demonstrate that eosinophil activation can be measured in urine in childhood asthma. Concentrations of U-EPX are related to disease activity and pulmonary function, as shown in both cross-sectional and longitudinal analyses, but are independent of atopy and treatment modalities. Measurement of U-EPX may be useful in assessing the inflammatory process and therefore in the management of childhood asthma.