title: Serum eosinophil cationic protein for predicting the prognosis of a step-down in inhaled corticosteroid therapy in adult chronic asthmatics.
abstract: We investigated whether the serum concentration of eosinophil cationic protein (s-ECP) can be used to determine when a step-down in inhaled corticosteroid therapy is indicated for patients with chronic asthma. A total of 24 adult patients, whose symptoms were well controlled with inhaled beclomethasone dipropionate (iBDP), were studied. The dosage of iBDP was reduced by half once a month until the dose reached one-quarter of the original level. s-ECP and blood eosinophil counts were determined once a month before and during the 6-month period after the step-down. In 12 patients, moderate and frequent exacerbation occurred, thus requiring a return to the initial or twice the initial dose of iBDP. Thus, the step-down here was defined as unsuccessful. In the remaining 12 patients, the symptoms were stable over the course of the 6 months, and the step-down was defined as successful. s-ECP correlated with eosinophil counts in peripheral blood (EOS) in both the successful and the unsuccessful groups. Although EOS before the step-down did not differ significantly between the two groups, s-ECP was significantly higher in the unsuccessful group (mean 35.7 microg/L) than in the successful group (mean 17.0 microg/L, p < 0.03). Thus, s-ECP appears to be a useful marker for determining when a step-down in iBDP therapy is indicated, and thus may contribute to successful long-term management of chronic asthma.
authors.affiliation: The 3rd Department of Internal Medicine, Aichi Medical University, Yazako, Nagakute, Japan. baken@mua.biglobe.ne.jp
authors.forename: K
authors.initials: K
authors.lastname: Baba
authors.forename: T
authors.initials: T
authors.lastname: Hattori
authors.forename: I
authors.initials: I
authors.lastname: Koishikawa
authors.forename: K
authors.initials: K
authors.lastname: Yoshida
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Takagi
mesh_terms: D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000097:blood / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood*; D001798:Blood Proteins / Q000032:analysis*; D047091:Eosinophil Granule Proteins; D004804:Eosinophils; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012260:Ribonucleases
chemical_list: D018927:Anti-Asthmatic Agents; D015415:Biomarkers; D001798:Blood Proteins; D047091:Eosinophil Granule Proteins; D005938:Glucocorticoids; D018836:Inflammation Mediators; D012260:Ribonucleases; D001507:Beclomethasone