Ratio of eosinophil cationic protein/eosinophil count as a new marker in children with acute asthma.
BACKGROUND
It is a matter of concern whether serum eosinophil cationic protein (ECP) can be considered as a disease marker in children with acute asthma being treated without corticosteroids.


METHODS
Fourteen children (nine male, five female, aged 6-12 years) with acute asthmatic exacerbation, administered the appropriate drugs, with the exception of systemic or inhaled corticosteroids, were examined. They were all free from apparent asthmatic attacks during a follow-up period of 1 month. Serum ECP, eosinophil count and forced expiratory volume in 1 s (FEV1) were measured at referral, on the day of discharge, 1 week and 4 weeks after discharge, respectively.


RESULTS
The ratio of ECP/eosinophil count (ECP:Eo ratio), expressed as micrograms of ECP (microgram/L)/the number of eosinophil (/microL) x 1000, was also evaluated as a marker of eosinophil activation. Compared with the value at referral, FEV1 (% predicted) significantly increased on the day of discharge (P < 0.05), 1 week after (P < 0.05) and 4 weeks after discharge (P < 0.05). However, serum ECP concentrations showed no significant changes during the follow-up period. Eosinophil count showed no significant changes on the day of discharge or 1 week after discharge, but significantly increased 4 weeks after discharge (P < 0.05). In contrast, the ECP:Eo ratio significantly decreased on the day of discharge (P < 0.05), 1 week after (P < 0.05) and 4 weeks after discharge (P < 0.05).


CONCLUSIONS
These data suggest that serum ECP is a poor disease marker in asthmatic children with acute exacerbation who receive no corticosteroid therapy, probably due to marked changes in the eosinophil count. However, the ECP:Eo ratio might be a better marker than serum ECP in such patients.
Imai
C
C
Department of Pediatrics, Niigata University School of Medicine, Japan. chihaya@med.niigata-u.ac.jp
Yamazaki
H
H
Tanaka
Y
Y
Matsunaga
M
M
Numata
O
O
Torigoe
K
K
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology*; D015415:Biomarkers / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis*; D002648:Child; D047091:Eosinophil Granule Proteins; D004804:Eosinophils; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D007958:Leukocyte Count; D008297:Male; D012129:Respiratory Function Tests; D012260:Ribonucleases; D012680:Sensitivity and Specificity
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D012260:Ribonucleases