Eosinophil cationic protein levels in induced sputum correlate with the severity of bronchial asthma

Activated eosinophils play an important role in the pathogenesis of bronchial asthma. In this study, we analyzed the inflammatory leukocyte population and the concentrations of eosinophil cationic protein (ECP) and albumin in induced sputum from patients with mild to severe asthma (n=36), and assessed the findings in relation to the severity of their asthma. Both the eosinophil numbers and the concentrations of ECP in the induced sputum were significantly increased in the patients with asthma compared with those in healthy subjects (n=9). There were significant positive correlations between the ECP levels and both the eosinophil counts (r=0.45) and the albumin concentrations (r=0.53). When the asthmatics were classified as having mild (n=12), moderate (n=14), or severe (n=10) asthma as evaluated by their symptoms and peak expiratory flow rate (PEFR), the ECP levels showed significant increases in accordance with the severity of asthma. The eosinophil counts in the patients with severe asthma were significantly higher than those in the patients with mild and moderate asthma; there was no significant difference between those with mild and moderate asthma. The eosinophil counts and ECP levels were also significantly positively correlated with the mean weekly total symptom scores (r=0.52 and r=0.48, respectively) and negatively with the mean percent PEFR on waking (r=-0.50 and r=-0.65, respectively) recorded for 2 weeks prior to the sputum collection. These findings suggest that the eosinophil activation in the airway is closely linked to the symptoms and airflow obstruction of asthma, and that the ECP concentration in induced sputum could serve as useful marker for evaluating the severity of asthma and monitoring airway inflammation to achieve the optimal control of asthma.