title: Lack of relationship between eosinophil cationic protein and eosinophil protein X in nasal lavage and urine and the severity of childhood asthma in a 6-month follow-up study.
abstract: BACKGROUND
  Recent studies suggest that eosinophil cationic protein (ECP) and eosinophil protein X (EPX) may be valuable markers of airway inflammation in various body fluids of asthmatic children. Most of these studies have relied on a single measure of inflammatory markers.
  
  
  OBJECTIVE
  We measured ECP and EPX in nasal lavage fluids (NALF) and urine samples in children with asthma over a 6-month period to study the relationship between inflammatory markers and clinical severity.
  
  
  METHODS
  Fourteen children with mild persisting asthma (mean age 11.7 years, SD 2.2) were recruited. All patients were on therapy including inhaled steroids. For a 6-month period asthma severity was monitored by at least monthly physical examination and pulmonary function tests. Daily morning and evening PEF, asthma symptoms and medication were recorded in diaries for the whole study period. Telephone interviews were performed between visits and additional visits were done in case of an increase in asthmatic symptoms or drop of PEF values under 80% of best value. An exacerbation was defined by a fall of FEV1 > 10% and an increase in asthma symptoms and additional need of beta2-agonist. NALF and urine samples were obtained at each visit and analysed for ECP (NALF only) and EPX.
  
  
  RESULTS
  Mean observation time was 186.4 days (SD 19.8). Thirteen patients completed the study. During the study period 11 exacerbations were observed in six patients. No significant associations between PEF, PEF variability (amplitude % of mean), daily symptoms, additional beta2-agonist, FEV1 and MEF50 and nasal ECP, nasal EPX and urinary EPX were found. However, at exacerbations an average increase of nasal ECP (9.3 vs 50.3 microg/L) and EPX (nasal EPX 36.4 vs 141.7 microg/L, urinary EPX 46.4 vs 74.1 microg/mmol creatinine) was observed.
  
  
  CONCLUSIONS
  Serial measurements of ECP and EPX in NALF and urine samples do not provide additional information for the practical management in monitoring childhood asthma.
authors.affiliation: University Children's Hospital, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Wojnarowski
authors.forename: B
authors.initials: B
authors.lastname: Roithner
authors.forename: D Y
authors.initials: DY
authors.lastname: Koller
authors.forename: G
authors.initials: G
authors.lastname: Halmerbauer
authors.forename: C
authors.initials: C
authors.lastname: Gartner
authors.forename: E
authors.initials: E
authors.lastname: Tauber
authors.forename: T
authors.initials: T
authors.lastname: Frischer
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000276:immunology / Q000652:urine*; D001798:Blood Proteins / Q000032:analysis*; D002648:Child; D047091:Eosinophil Granule Proteins; D047208:Eosinophil-Derived Neurotoxin; D004804:Eosinophils / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D008297:Male; D017817:Nasal Lavage Fluid / Q000737:chemistry*; D011446:Prospective Studies; D012260:Ribonucleases; D012720:Severity of Illness Index
chemical_list: D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D018836:Inflammation Mediators; D047208:Eosinophil-Derived Neurotoxin; D012260:Ribonucleases