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Serum eosinophil cationic protein in the evaluation of asthma severity in children
1Department of Pediatrics, Turku University Hospital, Finland.
Insights
Serum eosinophil cationic protein (ECP) shows limited value in diagnosing asthma or assessing its severity in children. Peripheral blood eosinophil counts are more reliable indicators for asthma diagnosis and severity evaluation.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Clinical Diagnostics
Background:
- Asthma diagnosis and severity assessment in children often rely on clinical evaluation and lung function tests.
- Biomarkers like serum eosinophil cationic protein (ECP) are explored for improved diagnostic accuracy.
Purpose of the Study:
- To evaluate the diagnostic sensitivity and specificity of serum ECP for asthma in children.
- To compare serum ECP levels with asthma severity parameters, peripheral eosinophilia, and bronchial hyperresponsiveness.
Main Methods:
- Prospective study involving 88 children with suspected or diagnosed asthma.
- Comparison of serum ECP concentrations with peripheral eosinophil counts, asthma severity scores, bronchial hyperresponsiveness, and lung function tests (FEV1, peak flow).
Main Results:
- Serum ECP showed a significant correlation with peripheral eosinophil counts (r=0.676) but a weak correlation with asthma severity (r=0.21).
- Serum ECP levels were significantly higher in atopic children compared to nonatopic children (P=0.01).
- Diagnostic sensitivity and specificity of serum ECP for active asthma were 54% and 71%, respectively, at a cutoff of 16 mg/l.
Conclusions:
- Serum ECP is not superior to peripheral blood eosinophil counts for diagnosing asthma or evaluating its severity in children.
- The diagnostic utility of serum ECP in pediatric asthma appears limited.
Abstract:
To assess the sensitivity and specificity of serum eosinophil cationic protein (ECP) in the diagnosis of asthma and evaluation of asthma severity, we conducted a prospective study to compare parameters of asthma severity, peripheral blood eosinophilia, and serum ECP concentrations in 88 children presenting to a university hospital outpatient clinic with suspected (n=59) or recently diagnosed asthma (n=29). Serum ECP correlated significantly (r[s]=0.676, P = 0.0001) with peripheral eosinophil counts, but only weakly with asthma severity (r[s]=0.21, P=0.046). Serum ECP was significantly higher in atopic children (25+/-11 microg/l) than in nonatopic children (16+/-15 microg/l) (P=0.01). Bronchial hyperresponsiveness had no significant correlation (r[s]= -0.21, P=0.30) with serum ECP. Lung function test results had no (peak flow) or only a weak (FEV1) correlation with serum ECP. In distinguishing between children with and without asthma or in assessing asthma severity, serum ECP is not superior to the peripheral blood eosinophil count. The diagnostic sensitivity and specificity of ECP in serum for detecting symptomatically active asthma, evaluated against the cutoff level of ECP in serum of 16 mg/l, were 54% and 71%, respectively.