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Inflammation markers and symptom activity in children with bronchial asthma. Influence of atopy and eczema
K H Carlsen1, R Halvorsen, M Pettersen
1Voksentoppen Center of Asthma, Allergy and Chronic Lung Diseases in Children, Oslo, Norway. kaic@ulrik.uio.no
Insights
Serum eosinophil cationic protein (ECP) in children with asthma is influenced by persistent symptoms, atopy, and active eczema. These factors, particularly persistent asthma symptoms, significantly impact ECP levels, aiding in symptom assessment.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Biomarkers in Asthma
Background:
- Eosinophil cationic protein (ECP) is a marker for eosinophilic inflammation in asthma.
- The influence of asthma symptoms and atopic eczema on serum ECP (s-ECP) in asthmatic children requires clarification.
Purpose of the Study:
- To investigate serum ECP (s-ECP) and serum myeloperoxidase (s-MPO) levels in relation to asthma symptoms and atopic eczema in children with asthma.
- To determine the relative impact of asthma severity and comorbidities on s-ECP levels.
Main Methods:
- Serum ECP and s-MPO were measured in 101 children (median age 9 years) with moderate to severe asthma.
- Assessment included symptom activity, lung function, exercise-induced bronchoconstriction, and bronchial responsiveness.
- Children were recruited from Voksentoppen Center.
Main Results:
- S-ECP levels were significantly elevated in children with persistent asthma symptoms compared to episodic or no symptoms.
- Children with atopic asthma and active atopic eczema showed higher s-ECP levels than non-atopic or those without active eczema.
- Persistent asthma symptoms had the most substantial effect on s-ECP, followed by atopy and active eczema.
Conclusions:
- Serum ECP can serve as an indicator of symptom activity in pediatric asthma.
- Clinicians should consider the potential influence of active eczema and atopy when interpreting s-ECP levels in asthmatic children.
Background:
Eosinophil cationic protein (ECP) has been reported to reflect the eosinophil inflammatory activity in asthma. However, the relative impact of asthma symptoms and atopic eczema upon serum (s)-ECP in asthmatic children has not been established.
Objectives:
To examine s-ECP levels and s-myeloperoxidase (MPO) in relation to asthma symptoms and atopic eczema in asthmatic children.
Methods:
S-ECP and s-MPO were assessed in relation to symptom activity, lung function, exercise-induced bronchoconstriction and bronchial responsiveness in 101 children; median age 9 years, range 1-16 years; with moderate to severe asthma, admitted to Voksentoppen Center.
Results:
S-ECP was significantly higher in children with persistent compared to episodic or no asthma symptoms in the past four weeks. S-ECP was also higher in children with atopic compared to non-atopic asthma, as well as in those with active compared to past history or no history of atopic eczema. S-MPO was higher in children with persistent asthma symptoms, but did not differ in relation to atopy or eczema state. Persistent asthma symptoms had the greatest impact upon s-ECP levels, followed by atopy and active eczema.
Conclusion:
S-ECP may be used in assessing symptom activity in asthmatic children, but with the realisation that active eczema and the presence of atopy may also influence levels.