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[Pattern of circulating eosinophils in allergic children suffering from infectious disease]
M Montesanti1, G Testa, C Biagi
1Regione Toscana, Azienda USL 2, Lucca.
Insights
In allergic children, acute infections cause a significant drop in circulating eosinophils, which then return to normal levels during remission. This eosinophil pattern helps monitor infection recovery in allergic patients.
Area of Science:
- Immunology
- Pediatrics
- Allergy Research
Background:
- Infections typically cause a decrease in circulating eosinophils, followed by a return to baseline during remission.
- This pattern's behavior in atopical (allergic) children during infections is not well-established.
Purpose of the Study:
- To investigate if the typical eosinophil count pattern during acute infections and remission is observed in atopical children.
- To assess the utility of eosinophil counts in monitoring infections in allergic children.
Main Methods:
- Retrospective study of atopical children (primarily asthmatic) with infections.
- Eosinophil counts were measured during acute infection and remission phases.
- A control group of 21 atopic children without infections was included.
Main Results:
- Children with acute infections had significantly lower eosinophil counts (25.1/mm³) compared to remission (241/mm³) and control groups (412.6/mm³).
- The typical fall and rise pattern was observed in 90% of infected children.
- A threshold of 100 eosinophils/mm³ could differentiate acute infection from remission or non-infected states.
Conclusions:
- Allergic subjects exhibit a significant reduction in eosinophils during acute infections, with levels returning to normal upon remission.
- Eosinophil count monitoring is a valuable tool for assessing acute infections and recovery in allergic children.
- Elevated eosinophil levels during remission indicate infection resolution and may reflect eosinophils' dual role in allergic vs. non-allergic inflammation.
Background And Aim:
Both bacterial and viral acute infections are accompanied by a typical fall in the number of circulating eosinophils followed, at remission, by a rapid return to starting values. The aim of this study was to check whether this typical pattern can be observed in atopical children.
Materials And Methods:
A retrospective study was performed in a group of atopical subjects (mainly asthmatic) suffering from intercurrent infectious diseases (mainly bronchopneumonia); circulating eosinophils were assayed during the acute phase of disease and during remission. The control group consisted of 21 atopic children without signs or symptoms of infectious diseases.
Results:
The mean number of circulating eosinophils was 412.6 +/- 199.8 in the control group of allergic children 25.1 +/- 39.7 in the group with acute infectious diseases and 241 +/- 137.5 in the group of children with infectious diseases during remission. The differences between the group of children with infectious diseases and that in remission were statistically significant. The typical pattern of the fall and rise of circulating eosinophils was observed in 9 out of 10 children with acute infections. The cut-off proposed as the discriminating factor between acute phase infection and subjects in remission or without infectious diseases was 100 eosinophils/mm3.
Conclusions:
During the course of infective pathologies in allergic subjects there is an abrupt and significant reduction in circulating eosinophils followed, during remission, by a return to levels comparable to those in controls. Eosinophil assay therefore appears to be a useful parameter to monitor acute infection in allergic subjects. In particular, increased eosinophil levels are an early indicator that the infection has been overcome and remission is in progress. The authors repropose the hypothesis that eosinophils play a double role that alternates between activating the allergic phlogosis and eliminating non-allergic phlogosis, depending on the cytokinic context in which this occurs.
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