title: CCL11 as a potential diagnostic marker for asthma?
abstract: OBJECTIVE
  Asthma is an inflammatory airway disease characterized by airway eosinophilia, in which CCL11 (eotaxin) plays a crucial role. The aim of study is to determine the elevation of CCL11 levels in bronchoalveolar lavage fluid (BALF), blood, exhaled breath condensate (EBC) and sputum in asthma patients and to identify which medium yields the most significant change in CCL11 level.
  
  
  METHODS
  The databases of PubMed, Embase and Cochrane Centre Register of Controlled Trials were systematically searched from inception to September 2013. Controlled clinical trials that focused on CCL11 concentrations in asthma patients and controls, and their correlations with other asthma indicators were obtained. Data were analysed using Stata 12.0.
  
  
  RESULTS
  Thirty studies were included in this investigation. CCL11 levels in blood, EBC and sputum were significantly higher in asthma patients than in healthy subjects. Sputum CCL11 concentrations were significantly elevated in unstable asthma patients versus stable asthma patients and in uncontrolled asthma patients versus partially controlled asthma patients. CCL11 levels in sputum and blood were negatively correlated with the lung function as measured by FEV1% predicted, and were positively correlated with BALF, EBC and sputum eosinophil counts. Similarly, CCL11 concentrations were positively correlated with eosinophil cationic protein in EBC, blood and sputum as well as with interleukin-5 in sputum and fractional exhaled nitric oxide in EBC. Steroid treatment had no significant effect on CCL11 levels.
  
  
  CONCLUSIONS
  CCL11 is a potentially useful biomarker for the diagnosis and assessment of asthma severity and control, especially in sputum. CCL11 is crucial in eosinophil chemoattraction and activation in asthma pathogenesis. Further studies using anti-CCL11 approaches are needed to confirm a role for CCL11 in asthma pathogenesis particularly in patients with more severe disease.
authors.affiliation: Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University , Guangzhou Road, Nanjing , China and.
authors.forename: Dandan
authors.initials: D
authors.lastname: Wu
authors.forename: Ji
authors.initials: J
authors.lastname: Zhou
authors.forename: Hui
authors.initials: H
authors.lastname: Bi
authors.forename: Lingling
authors.initials: L
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Mao
authors.initials: M
authors.lastname: Huang
authors.forename: Ian M
authors.initials: IM
authors.lastname: Adcock
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Barnes
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
mesh_terms: D001249:Asthma / Q000175:diagnosis*; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D054413:Chemokine CCL11 / Q000032:analysis*; D006801:Humans; D013183:Sputum / Q000737:chemistry
chemical_list: D015415:Biomarkers; D054413:Chemokine CCL11
keywords: Asthma; CCL11; blood; bronchoalveolar lavage fluid; exhaled breath condensate; sputum