title: Presence of eosinophils in nasal secretion during acute respiratory tract infection in young children predicts subsequent wheezing within two months.
abstract: BACKGROUND
  In young children with wheezing or bronchiolitis, especially with respiratory syncitial virus, blood eosinophilia and a high eosinophil cationic protein level in nasal secretions predicts subsequent wheezing in later childhood. However, whether eosinophil activation results from virus-induced inflammation or local eosinophilia per se precedes the onset of wheezing remains unknown. In the present study, we examined the association between the presence of nasal eosinophils during respiratory tract infection (RTI) and subsequent wheezing in young children.
  
  
  METHODS
  A total of 35 young children less than 3 years of age who visited our outpatient clinic with rhinorrhea between April and July 2004 were enrolled in this prospective cohort study. Subjects who were given diagnoses of allergic rhinitis were excluded. In all the subjects, the presence of eosinophils in nasal secretions was determined. The subjects were followed, and the cumulative incidences of wheezing during the subsequent 2- and 12-month periods were examined.
  
  
  RESULTS
  According to a logistic regression analysis adjusted for age, sex, family history, allergies, and wheezing at entry, young children with nasal eosinophil infiltration during acute RTI had a significantly higher risk of wheezing during the subsequent 2 months, compared with those without nasal eosinophil infiltration (adjusted odds ratio, 27.618, p = 0.016).
  
  
  CONCLUSIONS
  Our findings not only suggest that nasal eosinophil testing may serve as a convenient clinical marker for identifying young children at risk for subsequent wheezing, but also shed new light on the role of eosinophils in the onset of wheezing in young children.
authors.affiliation: Department of Pediatrics, Kochi Medical School, Kochi, Japan.
authors.forename: Miwa
authors.initials: M
authors.lastname: Shinohara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wakiguchi
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Saito
authors.forename: Kenji
authors.initials: K
authors.lastname: Matsumoto
mesh_terms: D000208:Acute Disease; D015415:Biomarkers; D012634:Bodily Secretions / Q000276:immunology*; D002675:Child, Preschool; D015331:Cohort Studies; D004804:Eosinophils / Q000276:immunology / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009297:Nasal Mucosa / Q000378:metabolism*; D009666:Nose / Q000276:immunology / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000209:etiology; D012141:Respiratory Tract Infections / Q000150:complications / Q000473:pathology*; D013997:Time Factors
chemical_list: D015415:Biomarkers