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Determinants of eosinophil cationic protein in nasal lavages in children
C Wojnarowski1, M Studnicka, J Kühr
1University Children's Hospital, Vienna, Austria.
Insights
Nasal lavages are useful for studying childhood airway inflammation, but individual results for eosinophil cationic protein (ECP) vary significantly. Multiple measurements are needed to accurately assess ECP levels in children for population studies.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Epidemiology
Background:
- Nasal lavages are increasingly utilized for assessing airway inflammation in pediatric populations.
- Limited research exists on the contribution of measurement error and biological factors to nasal inflammatory parameters in population-based surveys.
- Understanding these factors is crucial for accurate interpretation of nasal lavage data in children.
Purpose of the Study:
- To investigate the determinants of eosinophil cationic protein (ECP) concentration in nasal lavages among schoolchildren.
- To assess the reliability and variability of ECP measurements in a longitudinal pediatric study.
- To identify factors influencing ECP levels, including biological and measurement-related influences.
Main Methods:
- A cohort of 147 schoolchildren (mean age 8.1 years) underwent repeated nasal lavages over a 2-year period.
- Standardized parental questionnaires and skin-prick tests for seven common aeroallergens were administered annually.
- Intraclass correlation coefficients were calculated to assess the reliability of ECP measurements, with 101 children providing at least five valid lavages per year.
Main Results:
- The overall intraclass coefficient of reliability for ECP was 0.27, indicating substantial intraindividual variability.
- Averaging ECP concentrations annually improved reliability to 0.60.
- Higher ECP levels were significantly associated with male sex, sensitization to seasonal allergens, and the presence of serous or purulent rhinitis.
Conclusions:
- Nasal lavage assessment of inflammatory mediators like ECP is valuable for pediatric epidemiological research.
- The significant intraindividual variability in ECP concentrations necessitates multiple lavages for reliable individual characterization.
- Findings highlight the importance of considering biological factors and measurement variability when interpreting ECP data in children.
Background:
Nasal lavages are increasingly used to assess airways inflammation in children. However, there are no studies assessing how measurement error as well as biological influences contribute to the concentration of nasal inflammatory parameters in a population based survey.
Objective:
To investigate determinants of concentration of eosinophil cationic protein (ECP) in nasal lavages we studied 147 schoolchildren (mean age 8.1 years, SD 0.6 years) by repeated nasal lavages/year over a 2 year period.
Methods:
Standardized questionnaires were completed by the parents each year. A skin-prick test with seven aeroallergens (birch, cat, dog, hazel, weeds, Dermatophagoides pteronyssinus and D. farinae) was performed. One hundred and one children could perform valid lavages at least five times a year. As a measure of reproducibility the intraclass coefficient of reliability was calculated.
Results:
The intraclass coefficient of reliability was 0.27 over all observations suggesting that about a quarter of total variance is due to between-subject variance. Taking means over each year increased reliability to 0.60. Linear regression analyses with ECP being the dependent variable demonstrated significant higher values for boys (beta=12.26; P < 0.01), children sensitized to seasonal (beta=34.27; P=0.02) but not to perennial allergens (beta=-4.44; P=0.57), and for children with a serous (beta=10.01; P=0.01) or purulent rhinitis (beta=22.45; P < 0.001).
Conclusion:
Assessment of inflammatory mediators in nasal lavages is a useful tool for epidemiological paediatric studies. However, due to the relatively high intraindividual variability of ECP concentrations multiple lavages are necessary to characterize the individual.