Serum eosinophil cationic protein as a predictor of wheezing after bronchiolitis.
We have evaluated the role of eosinophil cationic protein (ECP) concentrations in serum in predicting wheezing after bronchiolitis, during infancy and early childhood. A prospective study at a university hospital serving all pediatric patients in a defined area was designed. Serum ECP concentrations were measured in 92 infants under the age of 2 years on admission for acute bronchiolitis, and 6 and 16 weeks after hospitalization. Nebulized anti-inflammatory therapy was initiated during hospitalization: 32 patients received cromolyn sodium and 32 patients received budesonide for 16 weeks; 30 control patients received no maintenance therapy. The numbers of subsequent physician-diagnosed wheezing episodes and hospital admissions for obstructive airway disease were recorded during 16 weeks of follow-up. At entry, 14 of 92 (15%) children had high (> or = 16 micrograms/L) levels of ECP in their serum. During the 16-week follow-up period, this group of patients had significantly more physician-diagnosed episodes of wheezing (86% vs. 43%, P < 0.01) and hospital admissions for wheezing (64% vs. 19%, P = 0.001) than those with serum levels of ECP < 16 micrograms/L. The number of patients with serum ECP > or = 8 micrograms/L was 25 (27%); 76% of this group developed physician-diagnosed wheezing (P < 0.01), and 48% had hospital admissions for wheezing (P < 0.01). Serum ECP levels decreased significantly with respect to time after bronchiolitis and did not differ among the three intervention groups. We conclude that a high serum ECP concentration during the acute phase of bronchiolitis is a specific but insensitive predictor of wheezing after bronchiolitis.
Reijonen
T M
TM
Department of Pediatrics, Kuopio University Hospital, Finland.
Korppi
M
M
Kuikka
L
L
Savolainen
K
K
Kleemola
M
M
Mononen
I
I
Remes
K
K
D000208:Acute Disease; D000704:Analysis of Variance; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis*; D001988:Bronchiolitis / Q000097:blood* / Q000175:diagnosis* / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage; D019819:Budesonide; D002675:Child, Preschool; D004205:Cromolyn Sodium / Q000627:therapeutic use; D047091:Eosinophil Granule Proteins; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D011237:Predictive Value of Tests; D011282:Pregnenediones / Q000008:administration & dosage; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000187:drug effects / Q000209:etiology*; D012260:Ribonucleases; D012680:Sensitivity and Specificity
D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D001798:Blood Proteins; D001993:Bronchodilator Agents; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D011282:Pregnenediones; D019819:Budesonide; D012260:Ribonucleases; D004205:Cromolyn Sodium