Eosinophil-related markers and total immunoglobulin E as a predictive marker for antibiotic response in chronic rhinosinusitis.
OBJECTIVE
Chronic rhinosinusitis (CRS) is a commonly diagnosed disease that has a significant impact on a child's quality of life. However, no useful biomarker is available to identify antibiotic-responsive CRS. We determined the significance of eosinophil-related markers and total IgE levels in childhood CRS with regard to antibiotic response.


METHODS
This was a case-control study of patients admitted to Uijeongbu St. Mary's Hospital between November 2010 and November 2011 and diagnosed with CRS.


METHODS
In this analytical cross-sectional study, we identified children whose symptoms and radiologic abnormalities did not resolve after 12 weeks despite appropriate antibiotics (non-responder CRS group), children whose symptoms and radiologic abnormalities resolved after 12 weeks with appropriate antibiotics (responder CRS group), and healthy controls selected from clinic patients. Skin prick tests were performed along with serum total IgE, total eosinophil count (TEC), serum eosinophil cationic protein (ECP) level, and ImmunoCAP analysis for common allergens.


RESULTS
This study included 36 responders, 22 nonresponders and 22 healthy controls. The prevalence of allergic diseases, atopy, and a family history of allergic diseases were significantly higher in the non-responder group than in the responder and control groups. TEC, ECP, and total IgE levels were significantly higher in the non-responder group than in the responder and control groups (all P < .05). Multiple linear regression analysis showed that no response to appropriate antibiotics and TEC was positively associated with ECP concentration.


CONCLUSIONS
These findings suggest that there is a high prevalence of allergic diseases in the non-responder group, that the TEC and ECP levels in the non-responder group are significantly higher than those in the responder group and controls, and that no response to antibiotics may be due to eosinophilic inflammation. The measurement of serum ECP may be useful in monitoring the progress of childhood CRS with regard to antibiotic response.
Youn Ho
YH
Shin
Jintack Kim MD, PhD, Department of Pediatrics, School of Medicine,, The Catholic University of Korea, 222,, Banpo-daero, Seocho-gu, Seoul 137-701,, Republic of Korea, T: +82-31-820-3017;, F: +82-31-821-3108, jintackk@catholic.ac.kr.
Hwan Soo
HS
Kim
Eu Kyoung
EK
Lee
Jintack Kim MD, PhD, Department of Pediatrics, School of Medicine,, The Catholic University of Korea, 222,, Banpo-daero, Seocho-gu, Seoul 137-701,, Republic of Korea, T: +82-31-820-3017;, F: +82-31-821-3108, jintackk@catholic.ac.kr.
Young Joo
YJ
Kim
Hyun-Seung
HS
Lee
Pil-Sang
PS
Jang
Jintack Kim MD, PhD, Department of Pediatrics, School of Medicine,, The Catholic University of Korea, 222,, Banpo-daero, Seocho-gu, Seoul 137-701,, Republic of Korea, T: +82-31-820-3017;, F: +82-31-821-3108, jintackk@catholic.ac.kr.
Young-Hoon
YH
Kim
Yoon Hong
YH
Chun
Jong-Seo
JS
Yoon
Jintack Kim MD, PhD, Department of Pediatrics, School of Medicine,, The Catholic University of Korea, 222,, Banpo-daero, Seocho-gu, Seoul 137-701,, Republic of Korea, T: +82-31-820-3017;, F: +82-31-821-3108, jintackk@catholic.ac.kr.
Hyun Hee
HH
Kim
Young-Yull
YY
Koh
Jintack Kim MD, PhD, Department of Pediatrics, School of Medicine,, The Catholic University of Korea, 222,, Banpo-daero, Seocho-gu, Seoul 137-701,, Republic of Korea, T: +82-31-820-3017;, F: +82-31-821-3108, jintackk@catholic.ac.kr.
Jin Tack
JT
Kim
D000485:Allergens / Q000276:immunology; D000900:Anti-Bacterial Agents / Q000276:immunology* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000188:drug therapy; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial / Q000276:immunology; D047150:Eosinophil Cationic Protein / Q000097:blood*; D004804:Eosinophils; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis; D007073:Immunoglobulin E / Q000097:blood*; D007958:Leukocyte Count; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D012220:Rhinitis / Q000097:blood* / Q000188:drug therapy / Q000382:microbiology; D012852:Sinusitis / Q000097:blood* / Q000188:drug therapy / Q000382:microbiology; D012882:Skin Tests
D000485:Allergens; D000900:Anti-Bacterial Agents; D015415:Biomarkers; D007073:Immunoglobulin E; D047150:Eosinophil Cationic Protein